Federal Register - August 4, 2021
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Source: Federal Register
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Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations
COVID19 PHE on hospices are captured for consumers. For these reasons, adding disclaimer text as suggested would not help consumers
seeking information make decisions about care options.
Final Decision: We are finalizing our proposal to resume public reporting of
HIS quality measures in February 2022
using data from Q3 and Q4 of 2020 and Q1 of 2021.
TABLE 17: Original, Revised and Proposed Schedule for Refreshes Affected b COVID-19 PHE Exem tions Quarter Refresh
November 2020
HIS Quarters in Original Schedule for Care Compare number of uarters Ql 2019- Q4 2019 4
February 2021
Q2 2019- Ql 2020 4
May 2021
Q3 2019-Q2 2020 4
August 2021
Q4 2019- Q3 2020 4
November 2021
Ql 2020- Q4 2020 4
February 2022
Q2 2020-Ql 2021 4
HIS Quarters in revised/proposed Schedule for Care Compare number of uarters QI 2019- Q4 2019 4
Note: The shaded cells represent data frozen posted and held constant on Care Compare due to COVID-
4. Proposal for Public Reporting of CAHPS Hospice Survey-based Measures Due to COVID19 PHE
Exemption Prior to COVID19 PHE, the CAHPS
Hospice Survey publicly reported the most recent eight rolling quarters of data. We propose to continue to report the most recent 8 quarters of available data after the freeze, but not to include the data from the exempted quarters of Q1 and Q2 of 2020 as issued in the March 27, 2020 Guidance Memorandum with the effected quarters. The optional data submission for Q4 2019 results in publicly reporting of that data since the CAHPS Hospice Survey from that quarter were not impacted. The data submitted for Q4 2019 referred to deaths that occurred prior to COIVD19. For the CAHPS Hospice Survey, 2.1 percent more hospices submitted data in Q4
2019 than in the same quarter a year earlier.
Like HIS, our goal is to report as much of the most recent CAHPS Hospice Survey data as possible, to display data for as many hospices as possible, and to maintain the reliability of the data.
Similar to HIS, the CAHPS Hospice Survey reviewed the data for
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reportability using fewer quarters than normal. However, we found that using fewer than 8 quarters of data would have two important negative impacts on public reporting. First, it would reduce the proportion of hospices that would have CAHPS Hospice Survey data displayed on Care Compare. An analysis of the 8 quarters of data from Q1 2018
through Q4 2019 publicly reported in November 2020 shows there were 5,041
active hospices. Of these hospices: 2,941
58.3 percent had 30+ completes for those 8 quarters, and had scores publicly reported. Fewer hospices, 2,328 46.2 percent, would have had 30+ completes if 4 quarters of data were used to calculate scores and 1,970 39.1
percent would have 30+ completes if 3
quarters were used to calculate scores.
In addition, the overall reliability of the CAHPS scores would decline with fewer quarters of data. For these reasons, we determined the best course of action would be to continue to publicly report the most recent 8 quarters of data, but exempting Q1 and Q2 2020. This will allow us to maximize the number of hospices that will have CAHPS scores displayed on Care Compare, protect the reliability of the data, and report as
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much of the most recent data as possible.
CMS froze CAHPS data starting with the November 2020 refresh and concluding with the November 2021
refresh. We propose that starting with the February 2022 refresh, CMS will display the most recent 8 quarters of CAHPS Hospice Survey data, excluding Q1 and Q2 2020. We will resume public reporting by displaying 3 quarters of post-exemption data, plus five quarters of pre-exemption data. Please see Table 18. We propose that in each refresh subsequent to February 2022, we will report one more post-exemption quarter of data and one fewer pre-exemption quarter of data until we reach eight quarters of post-exemption data in May of 2023. We further propose that as of August 2023, we will resume reporting a rolling average of the most recent 8
quarters of data. Table 18 specifies the quarters for each refresh. This will allow us to report the maximum amount of new data, maintain reliability of the data, and permit the maximum number of hospices to receive scores. In addition, Table 18 shows the proposed CAHPS public reporting schedule during and after the data freeze.
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