• J Pain Symptom Manage · Feb 2018

    Nationwide Quality of Hospice Care: Findings from the Centers for Medicare & Medicaid Services (CMS) Hospice Quality Reporting Program (HQRP).

    • Nan Tracy Zheng, Qinghua Li, Laura C Hanson, Kathryn L Wessell, Natalie Chong, Noha Sherif, Ila H Broyles, Jennifer Frank, M Alexis Kirk, Carol R Schwartz, Alan F Levitt, and Franziska Rokoske.
    • RTI International, Research Triangle Park, North Carolina, USA. Electronic address: ntzheng@rti.org.
    • J Pain Symptom Manage. 2018 Feb 1; 55 (2): 427-432.e1.

    ContextWith 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. Toward these goals, Centers for Medicare & Medicaid Services has been collecting standardized patient-level quality data via the Hospice Item Set (HIS) since July 1, 2014.ObjectiveThis article presents a first look at the national hospice HIS quality data.MethodsWe 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).ResultsOur sample included 1,218,786 hospice patients discharged from 3922 hospices from October 1, 2014 to September 30, 2015. More than 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.ConclusionsMost hospices conduct critical assessments and discuss treatment preferences with patients at admission, although few hospices have perfect scores.Copyright © 2017. Published by Elsevier Inc.

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