Federal Register - August 4, 2021
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Fuente: Federal Register
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Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations have gone through Review and Correct processes, have been issued in a provider preview report, and have time allotted for addressing requests for data suppression before being publicly reported. As discussed in the FY 2017
Hospice Wage Index and Payment Rate Update final rule 81 FR 52183, CMS
requires at least 4 quarters of data to establish the scientific acceptability for our HIS-based quality measures. For CAHPS-based measures, we have reported CAHPS measures using eight rolling quarters of data on Hospice
2020 through March 30, 2020, and Quarter 2 Q2 2020 April 1, 2020
through June 30, 2020. We discuss the impact to the HIS here, and the impact to the CAHPS Hospice Survey further in section F.10.b.4. For HIS, the quarters are defined based on submission of HIS
admission or discharge assessments.
The exemption has impacted the public reporting schedule. Since launching Hospice Compare in 2017, HIS-measures have been reported using 4 quarters of data. The 4 quarters included are the most recent data that
Compare since 2018. In the FY 2017
Hospice Wage Index and Payment Rate Update final rule 81 FR 52143, we stated that we would continue CAHPS
reporting with eight rolling quarters on an ongoing basis. This original public reporting schedule included the exempted quarters of Q4 2019 and Q1
and Q2 2020 in six refreshes for HIS and 11 refreshes for CAHPS. Table 13
displays the original schedule for public reporting prior to the COVID19 PHE.
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TABLE 13: Original Public Reporting Schedule with Refreshes Affected by COVID -19 PHE Exemp fions or th e HQRP
Quarter Refresh
November 2020
HIS Quarters in Original Schedule for Care Compare Ql 2019- Q4 2019
CAHPS Quarters in Original Schedule for Care Compare Ql 2018-Q4 2019
February 2021
Q2 2019- Ql 2020
Q2 2018-Q 1 2020
May 2021
Q3 2019-Q2 2020
Q3 2018-Q2 2020
August 2021
Q4 2019- Q3 2020
Q4 2018-Q3 2020
November 2021
Ql 2020- Q4 2020
Q 1 2019-Q4 2020
February 2022
Q2 2020-Ql 2021
Q2 2019-Ql 2021
tMay 2022
Q3 2020-Q2 2021
Q3 2019-Q2 2021
t August 2022
Q4 2020-Q3 2021
Q4 2019-Q3 2021
tNovember 2022
Ql 2021-Q4 2021
Q 1 2020-Q4 2021
tFebruary 2023
Q2 2021-Ql 2022
Q2 2020-Ql 2022
tMay 2023
Q3 2021-Q2 2022
Q3 2020-Q2 2022
Exemption affects both HIS and CARPS data for refresh; tExemption affects only CARPS data for
lotter on DSK11XQN23PROD with RULES4
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During the spring and summer of 2020, we conducted testing to inform decisions about publicly reporting data for those refreshes which include exempt data. The testing helped us develop a plan for posting data as early as possible, for as many hospices as possible, and with scientific acceptability similar to standard threshold for public reporting. The following sections provide the results of our testing and explain how we used the results to develop a plan that we believe allows us to achieve these objectives as best as possible.
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2. Update on Use of Q4 2019 Data and Data Freeze for Refreshes in 2021
In the March 27, 2020 Guidance Memorandum, we stated that we should not include any post-acute care PAC
quality data that are greatly impacted by the exemption in the quality reporting programs. Given the timing of the COVID19 PHE onset, we determined that we would use any data that was submitted for Q4 2019. We conducted analyses of those data to ensure that their use was appropriate. In the original schedule Table 13 the November 2020 refresh includes Q4
2019 data for HISand CAHPS-based
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measures Q1 through Q4 2019 for HIS
data and Q1 2018 through Q4 2019 for CAHPS data and is the last refresh before Q1 2020 data are included.
Before proceeding with the November 2020 refresh, we conducted testing to ensure that, even though we made an exception to reporting requirements for Q4 2019 in March 2020, public reporting would still allow us to publicly report data for a similar number of hospice providers, as compared to standard reporting.
Specifically, we compared submission rates in Q4 2019 to average annual rates Q4 2018 through Q3 2019 to assess the
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refresh.
