Nationwide Quality of Hospice Care: Findings From the Centers for Medicare & Medicaid Services Hospice Quality Reporting Program

Abstract

Most hospices conduct critical assessments and discuss treatment preferences with patients at admission, although few hospices have perfect scores.

Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

“…Patients near EOL have expressed preference for spending their final days at home as opposed to in a hospital or nursing home, and for palliative medications and comfort care, as opposed to lifeprolonging treatments for short extensions of life. 17,18 Moreover, hospice enrollment is associated with improved EOL quality measures developed by the National Quality Forum, 19,20 and overall satisfaction with hospice services is associated with previously identified concepts of a 'good death'. 21 Recently, CMS started incentivizing providers for planning discussions to promote EOL care consistent with patient preferences.…”

Associations Between Certificate of Need Policies and Hospice Quality Outcomes

“…21 As a National Quality Forum-endorsed tool used by Medicare since 2014 to obtain quality data on Medicarecertified hospices, hospice agencies are required to electronically submit HIS data to CMS for each enrolled patient. 22 The eighth composite measure was added to HIS reporting in 2017. 21 These measures are all part of the Hospice Quality Reporting Program, 23 which is required by Section 1814(I) (5) of the Social Security Act and contribute to the reporting for Care Compare, a website created in 2020 to help consumers compare hospice providers' performance and choose a provider.…”

“…24 The 7 HIS measures include 4 care processes required for all hospice patients aged 18 or older: treatment preferences assessed, beliefs and values addressed if desired by the patient, pain screening, and dyspnea screening. 22 Three conditional measures are completed as applicable: pain assessment, dyspnea treatment, and patients treated with an opioid who are given a bowel regimen. 22 These items are reported on the CMS provider dataset and measured in percentages of how often the item was completed (the numerator) relative to the total number of patients eligible for a given indicator (the denominator).…”

“…22 Three conditional measures are completed as applicable: pain assessment, dyspnea treatment, and patients treated with an opioid who are given a bowel regimen. 22 These items are reported on the CMS provider dataset and measured in percentages of how often the item was completed (the numerator) relative to the total number of patients eligible for a given indicator (the denominator). 25,26 Thus, outcomes are reported as a percentage-based score for each HIS measure.…”

Effects of Caregiver and Decedent Characteristics on CAHPS Hospice Survey Scores

“…3e5 In 2012, the Centers for Medicare & Medicaid Services (CMS) introduced the Hospice Quality Reporting Program to measure and compare the quality of care provided by hospices. In the Hospice Quality Reporting Program, hospices must submit data on clinical quality measures 6 in the Hospice Item Set, and since 2015, collect data on patient and family experiences of hospice care using the Consumer Assessment of Healthcare Providers and Systems (CAHPS Ò ) Hospice Survey to avoid a financial penalty. 7,8 Public reporting of hospice performance on CAHPS Hospice Survey measures began in 2018.…”