CMS Developing Replacement for Hospice Item Set


As a part of its Hospice Quality Reporting Program (HQRP)the Centers for Medicare and Medicaid Services (CMS) recently hosted a webinar to update hospice providers on the pilot study of the Hospice Evaluation and Reporting Tool (HEART) that is planned to replace the Hospice Item Set. This reporting tool is currently being used by hospice providers to report quality measures gathered at the time of a patient’s hospice admission and discharge. CMS showed a level of transparency and engagement in this webinar that offered several key insights.   

New Assessment Tool 

Hospice providers are the only sector of post-acute care without a comprehensive assessment tool used to collect and report data to CMS. The agency is working to create an assessment tool to align with other post-acute sectors. The goal is to have hospice providers collect and track more meaningful data that is, most likely, going to be eventually tracked to reimbursement.  Hospice providers have long been concerned that this type of assessment, thought to be much like the OASIS assessment used in home healthwill be burdensome and interfere with interdisciplinary, specialized care they provide.  

The first version of the HEART was released for beta testing in early 2019.  The beta testing was cancelled shortly after it began. CMS webinars following the release and recall of the initial HEART lacked the coordination between CMS and providers needed to move forward.  

Developing the New HEART 

During the most recent call this month, team members of the CMS HQRP team explained the process they will use to create the new HEART.  The development will include information gathering, preliminary draft development, alpha and beta testing to refine the assessment, rulemaking and national implementation.  

Currently, the team is in the process of collecting information. This year CMS held listening sessions at conferences for both the National Association for Home Care and Hospice and the National Hospice and Palliative Care Organization. They are also conducting literature reviews and will be conducting focus groups.  

Hospice providers who would like to participate in the development of the HEART tool can be a participant in one of nine focus groups being held this summer. These focus groups will provide feedback about the following: 

  • What it means to provide quality hospice care 
  • How the HEART can measure holistic, patient-centered care 
  • What is important in an assessment tool 
  • Any concerns that participants may have 
  • How the HEART can assist in meeting the needs of the patient and their loved ones 
  • How data can be collected without interfering with the care of the declining and/or dying patient, among other things. 

If you would like to be a participant in one of the focus groups, CMS will be posting updates on their Hospice Quality Reporting website.  If you have questions or comments for the HQRP team, you can send to the HQRP monitored email HospiceAssessment@cms.hhs.gov.