Hospice Quality: Preview of Hospice Item Set (HIS) V.2.00.0 and New HQRP Q&As Released
April 29, 2016 12:15 PM
As referenced in coverage of the recently-issued hospice payment rule for FY2017, the Centers for Medicare & Medicaid Services (CMS) has submitted a request for approval to the Office of Management and Budget (OMB) for the Hospice Item Set version 2.00.0 that incorporates the four new HIS items. The PRA version has a posting date of 4/22/2016 although it was not available for viewing until 4/26/2016.
As described in the proposed FY2017 rule, CMS is adding four new items to the HIS-Discharge. The four items are contained under a new section, Section O – Service Utilization. The four new measures are:
O5000 Level of care in final 3 days
O5010 Number of hospice visits in final 3 days
O5020 Level of care in final 7 days
O5030 Number of hospice visits in 3-6 days prior to death
As shown below, hospices will answer a gateway yes/no question to indicate if the patient was receiving the routine home care level of care in the final 3 days of life and provide the number of visits on each of these three days for each of five disciplines.
The same type of information will be provided for the last 3-6 days prior to death for measures O5020 and O5030, as shown below.
There were also some additions to the HIS-Admission, primarily for the purpose of calculating quality measures and for public reporting. Measures added to the HIS-Admission and the reasons for adding them are:
AO550 Patient ZIP code – needed for public reporting
A1400 Payor information – needed for record matching and management
JO905 Pain active problem – needed to calculate measure
JO900 Change skip pattern for pain screen – needed to calculate measure
According to the proposed rule, hospices would not begin collecting this data until April 1, 2017 – for admissions and discharges occurring on or after this date.
The PRA listing with a link to the HIS-Admission and HIS-Discharge is found at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-R-245.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending
We will provide additional information as it becomes available.
In addition, to the PRA listing, a new HIS Q&A Document is available on the CMS HIS Hospice Quality Reporting webpage. The Q+A document reflects frequently asked HIS related questions that were received by the Quality Help Desk during the first quarter (January-March) of 2016. This document also contains quarterly updates and events from the first quarter as well as upcoming updates for the next quarter.