The Centers for Medicare & Medicaid Services (CMS) has just released the FY2025 Hospice Payment Rate Update Proposed Rule. Here is a quick breakdown and what you should know.
Per Diem Base Rate Increase: Should the proposal be finalized, hospice providers will see a 2.6% increase in the per diem base rate. This is an indication that CMS may not follow through with the recommendation to freeze rates at the current level.
Hospice Cap Amount Adjustment: The proposed hospice cap amount for FY 2025 is $34,364.85, an increase from the current $33,494.01.
New Wage Index Model: Starting in 2025, CMS plans to implement a new model using the wage index to determine payment rates, which will involve adjustments based on the varying wage rates across different markets. To ease this transition, CMS is capping the loss any provider can experience at 5% of their adjusted amounts.
Permanent Cap on Wage Index Decrease: With the recent OMB statistical area updates, CMS proposes a permanent 5% cap on any decrease in the wage index year-over-year, ensuring that the wage index does not fall below 95% of the previous year's index.
Quality Reporting Program Measures: Two new process measures are proposed for the Hospice Quality Reporting Program, focusing on the timely reassessment of pain and non-pain symptom impact, to be potentially implemented in FY 2028.
Introduction of the HOPE Tool: CMS expects to roll out the Hospice Outcomes & Patient Evaluation (HOPE) tool in 2025, a more comprehensive data collection tool than the current Hospice Item Set (HIS), capturing patient data throughout the hospice stay to bolster quality measures.
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