Construction and Performance of the Hospice Care Index Claims-Based Quality Measure

• Published in: Journal of pain and symptom management 2022-05, Vol.63 (5), p.876-876
• Main Authors: Plotzke, Michael, Christian, Thomas, Groover, Kimberly, Harrison, Zinnia, Massuda, Cindy
• Format: Article
• Language: English
• Subjects: Beneficiaries; Caregivers; End of life decisions; Hospice care; Hospices; Medicaid; Medicare; Patient satisfaction; Policy making; Quality management
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2022.02.072

1. Determine how the hospice care index is constructed 2. Identify broad trends in the measures As part of the Medicare Hospice Benefit (MHB), hospices submit claims containing information that allows policymakers to assess hospice quality, help policymakers improve the MHB, and increase patients’ experiences of care. We examine 10 different hospice quality indicators related to the provision of services and patterns of live discharge. We calculated indicators by using 100% Medicare fee-for-service (FFS) claims from October 1, 2018 through September 30, 2019. A hospice's total score among all 10 indicators is referred to as their Hospice Care Index (HCI), with a possible high score of 10. We examined all hospices with at least 20 discharges. After exclusions, we examined 4,155 hospices representing 1,562,003 beneficiaries. Most hospices earn a high HCI score: More than 85% of hospices had scores of 8 or more. At the same time, there were some lower-scoring hospices: 1 in 10 hospices scored 7 on the index, and the remaining 4.9% scored 6 or lower. We found that on average hospices with higher HCI scores have better CAHPS® Hospice ratings. Among hospices with a score of 10, 85.1% of caregivers reported they would definitely recommend the hospice versus 82.9% of caregivers of patients receiving treatment from hospices with a score of 7 or less. Using the HCI, the Centers for Medicare and Medicaid Services and hospice patient caregivers can assess hospices across a broad set of indicators. Although not earning a point for 1 indicator does not indicate a serious problem, not earning a point for several measures suggests a concerning pattern of service across multiple dimensions of care including providing too little care, enrolling patients not eligible for the benefit, and lack of consistency in treatment at the end of life. Policymakers and hospices should monitor these 10 indicators to understand their performance relative to peers.