CMS finalizes Medicare rate updates, quality measure changes for hospices, inpatient rehabilitation facilities

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The Centers for Medicare & Medicaid Services recently finalized 2014 Medicare rate updates for hospices and inpatient rehabilitation facilities, and also laid out quality metrics.

Hospices will receive a Medicare payment rate increase of 1.7%, which represents about $160 million in additional payments for the fiscal year starting Oct. 1, according to the rule published in today's Federal Register.

Starting in July 2014, hospices will begin to use new quality reporting guidelines, which are explained in the final rule. The measures include seven data items endorsed by the National Quality Forum, such as pain screening, dyspnea screening, and treatment preferences.

Under the Affordable Care Act, hospices must submit quality measure data or face Medicare reimbursement penalties.

The final rule also includes an update on hospice payment reform, clarifies proper diagnoses reports on hospice claims, and implements the hospice Experience of Care survey starting on Jan. 1, 2015.

The Medicare rate for inpatient rehabilitation facilities will increase 2.3% in 2014, resulting in about $170 million in additional payments, according to the final rule published yesterday in the Federal Register.

IRFs also must report on quality measures, and the final rule has three new measures: all-cause unplanned readmissions for 30 days post-discharge; percent of residents/patients assessed and appropriately vaccinated for the seasonal influenza (short-stay); percent of residents/patients with pressure ulcers that are new or worsened (short-stay).

For the pressure ulcer measure, the current IRF-Patient Assessment Instrument pressure ulcer items will be replaced to more closely match the Minimum Data Set 3.0 items used by nursing homes. This will help reduce administrative burdens, according to CMS.