In The News

CMS Hospice Quality Reporting Programs Updates


On August 4, 2022 CMS announced the following updates that go into effect with this month’s HQRP data refresh.

• Hospice Visits in the Last Days of Life (HVLDL): On July 26, 2022, the National Quality Forum (NQF) endorsed the claims-based measure, Hospice Visits in the Last Days of Life, or HVLDL as NQF #3645. According to CMS “HVLDL reflects the proportion of hospice patients who received in-person visits from a registered nurse or a medical social worker on at least two of the final three days of life. HVLDL is the re-specified measure replacing the HIS-based Hospice Visits When Death is Imminent (HVWDII).” The August 2022 refresh will be the inaugural month for public reporting for HVLDL, which replaces public reporting of HVWDII. Further information, including a link to the NQF website, can be found on the Hospice Quality Reporting Program (HQRP) Quality Measure Development webpage.

• Public Display of Hospice Care Index (HCI): Public reporting will also be available for the HCI measure during the August 2022 HQRP data refresh. The HCI is a single Medicare claims-based measure that includes 10 indicators of hospice stay, including indicators like burdensome transition and visits near the end of life. The HCI Technical Report has been made available for download effective July 1, 2022.

• Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Star Ratings: CMS is targeting the August 2022 refresh for inaugural public reporting of the new Family Caregiver Survey Rating Summary Star Rating for the CAHPS Hospice Survey measure scores. Beginning this month, it will be publicly reported for all hospices with 75 or more completed surveys over the reporting period. Star Ratings will be updated every other quarter (every six months). Prior to public reporting, CAHPS Hospice Survey results are adjusted for effects of mode of survey administration and case mix. Details with overview of the purpose, timeline and methods can be found on the website. The national and state Star Rating distribution reports for the most recent reporting periods are available for download.

Additionally, CMS shared two new videos with helpful explanations on HQRP and HCI:

HQRP: Hospice Care Index Measure (HCI) Informational Video

HQRP Explanatory Video

For questions, email [email protected].


Understanding How Sound Suppresses Pain

National Institutes of Health (NIH)

Studies dating back decades have shown that music and other kinds of sound can help alleviate acute and chronic pain in people. This is true for pain from dental and medical surgery, labor and delivery, and cancer. However, how the brain produces this pain reduction, called analgesia, was less clear.

An international team of scientists set out to use mice to explore the neural mechanisms through which sound blunts pain. The team was led by researchers at NIH’s National Institute of Dental and Craniofacial Research (NIDCR); the University of Science and Technology of China, Hefei; and Anhui Medical University in Hefei, China. Their study was published in Science on July 8, 2022.

The scientists first exposed mice with inflamed paws to three types of sound: a pleasant piece of classical music, an unpleasant rearrangement of the same piece, and white noise. Surprisingly, all three reduced pain sensitivity in the mice when played just slightly louder than background noise (about the level of a whisper). The effect lasted well beyond the sound itself—for at least two days after exposure to the sound three days in a row for 20 minutes. When played louder, the sounds had no effect on the animals’ pain responses.

Pain perception can be affected by emotions and stress. However, the scientists discovered that low-intensity sound didn’t affect the mice in tests of stress and anxiety. The finding shows that this particular type of sound affected the animal’s perception of pain through another mechanism.

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With Choose Home Up In the Air, Providers Consider Preparation Strategies

Home Health Care News / By Andrew Donlan
The home health industry at large is excited about the prospects of the Choose Home Care Act of 2021.
For now, it’s been tabled in Washington, D.C., due to a variety of reasons, including it being an election year. It’s also – to some extent – been cast aside in home providers’ minds, given all the mayhem going on related to the Centers for Medicare & Medicaid Services’ (CMS) proposed rule for 2023.
If the Choose Home legislation does come to fruition, it could be a massive tailwind for providers. The catch is that not all providers will benefit.
Instead, the ones that will benefit will be the ones that become designated Choose Home agencies. And in order to become that, they’ll likely need to begin prepping now for a bill that could come through as early next year, or never come to fruition at all.
“If this sounds good to you, what you should be working on now is to prepare yourself so that you can become a designated Choose Home agency,” Deborah Hoyt, senior vice president of public policy for Axxess, said last week at the National Association for Home Care & Hospice’s (NAHC) Financial Management Conference.
Dallas-based Axxess is technology company that develops cloud-based software solutions for home health, home care and hospice agencies across the country.
Broadly, Choose Home would allow for more skilled nursing facility (SNF) diversion in post-acute care, allowing home health agencies – utilizing an add-on to their existing home health benefit – to care for more higher-acuity patients in the home.
“Though it’s not yet enacted, there’s a lot of things that you can start doing today to help your organization prepare questions that you need to be asking,” Maria Warren, the VP of clinical consulting at McBee Associates, also said at FMC. “In approaching anything, whether it be Choose Home, a hospital-at-home program, diversifying services or implementing new technology, you want to take everything into a strategic assessment.”
That strategic assessment should include five steps, Warren said:
– Establish governance, strategy team and pilot team.
– Outline the current state of the agency, collecting as much data as possible, as well a GAP analysis
– Conduct external assessment – analyzing competitors, the market and other findings. This step should also include considering partnerships as well as other M&A opportunities.
– Act on data: “Look to integrative technologies and AI to better align staff to your patient population needs. Use predictive analytics to identify patient needs and prioritize patient visits.”
– Continuously measure and monitor; the final step is to use data to drive action and accountability internally and externally to get desired results
To prepare or not
The steps to preparing for Choose Home raise another question for every home health agency: ‘Is this worth my time?’. . .
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Monkeypox a Federal Public Health Emergency

Last Thursday, 08/04/2022, the Biden administration declared a federal public health emergency (PHE) for monkeypox.

During a call with reporters, HHS Secretary Xavier Becerra said that some 6,600 cases of the virus had already been reported for the week compared to less than 5,000 the week before.

The virus has spread primarily through close contact with someone who is infected. Treatment includes isolation and pain management, often at home. It is rarely fatal.

Designating the outbreak as a PHE allows federal agencies to access emergency funding and allocate funds and other resources to help prevent the spread of the virus. Such declarations also permit the waiver of some laws and requirements to allow healthcare providers to respond to the disease.

On July 23 the World Health Organization (WHO) declared a global health emergency over the outbreak.


Impact of Proposed Home Health Rule is Significant

The attached Dobson and Davanzo table includes the impacts of the 7.69%, the impact of the “clawback” of the temporary adjustments (for the 2020-2021 data and then an estimate of the impact of the 2022 clawback) for all 50 states.

The Partnership for Medicaid Home-Based Care will be creating state one pagers with this data – demonstrating the impact on each state. Stay tuned. HHAC will circulate the one-pages once they are finalized.

Please urge Congress to sign onto the Preserving Access to Home Health Act (S.B. 4605) that has been introduced into both the Senate and the House. The bill would freeze the current payment rate in place, with the exception of annual market basket updates, through 2025. 

Calls and personal messages are best, but for those short on time a message has been pre-drafted and is ready to go in the NAHC Virtual Advocacy Center.  

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