Nationwide quality of hospice care: Findings from the Centers for Medicare & Medicaid Services (CMS) Hospice Quality Reporting Program (HQRP)
BACKGROUND: With increasing use of the Medicare hospice benefit, policymakers recognize the need for quality measurement to assure that terminally ill patients receive high quality care and have the information they need when selecting a hospice. Towards these goals, CMS has been collecting standardized patient-level quality data via the Hospice Item Set (HIS) since July 1, 2014.
OBJECTIVES: This article presents a first look at the national hospice HIS quality data.
RESEARCH DESIGN: We calculated seven quality measures using the HIS data. These measures are endorsed by the National Quality Forum and focus on important care processes hospice providers are required to perform at admission, including discussion of patient preferences regarding life-sustaining treatments; care for spiritual and existential concerns; and symptom management (pain, opioid-induced constipation and dyspnea).
RESULTS: Our sample included 1,218,786 hospice patients discharged from 3,922 hospices from 10/1/2014-9/30/2015. Over 90% of patients received screenings and assessments captured by six of the seven quality measures. The only exception was pain assessment, for which the national mean score was 78.2%. A small number of hospices (156, 4.0%) had perfect scores for all seven quality measures.
CONCLUSIONS: Most hospices conduct critical assessments and discuss treatment preferences with patients at admission, although few hospices have perfect scores.