Hospice Final Rule FY 2025: Your Questions Answered – Webinar Recap

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The Centers for Medicare & Medicaid Services (CMS) recently released the Hospice Final Rule for Fiscal Year 2025, introducing several significant changes that will impact hospice providers nationwide. To help hospice agencies navigate these updates, SimiTree hosted a webinar featuring experts Michael Simione, MBA, Managing Director, and Maureen Kelleher, RN, MBA, Senior Manager, who provided essential insights into the rule’s implications.

During the webinar, Simione and Kelleher dove deep into the intricacies of the Hospice Final Rule, covering critical provisions, potential financial impacts, and strategies for adapting to the new regulations. Attendees gained a clear understanding of how the changes will affect their hospice organizations and the steps they can take to ensure compliance and continue delivering exceptional care.

Key Highlights from the Hospice Final Rule Webinar

  1. Critical Provisions of the New Hospice Final Rule: The presenters outlined the most significant updates in the rule, including revisions to reimbursement rates, changes to the Hospice Quality Reporting Program, and modifications to the Hospice Wage Index.
  2. Potential Financial Implications for Hospice Organizations: Simione and Kelleher delved into the financial considerations for hospice providers, discussing the impact of the revised reimbursement rates and strategies for managing the changes.
  3. Strategies for Adapting to the New Regulations: The experts shared practical advice and actionable steps hospice agencies can take to adapt to the Hospice Final Rule, including adjusting operational processes, updating compliance measures, and leveraging data-driven insights. Read our recent blog on everything you need to know about HQRP and avoiding non-compliance.

You asked, we answered: Questions we got on the CMS Hospice Final Rule for FY 2025

Q: When will the HOPE instrument be implemented and start impacting quality scores? How does HOPE work for inpatient hospices?

A: The HOPE instrument will be implemented starting October 1, 2025, when hospices will begin using and submitting the instrument. However, for the first year from October 1, 2025 to September 30, 2026, the data collected will be used by Medicare to test the reliability and validity of the instrument. It will not count towards hospice quality scores during that first year. Starting October 1, 2026, the HOPE instrument data will then begin to count towards hospice quality measures and scores.

Q: For hospices that had a proposed wage index reduction of more than 5%, how will that impact their wage index in 2026 and 2027?

A: For hospices that had a proposed wage index reduction of more than 5%, the following will likely happen:

    • The wage index will be capped at a 5% reduction for 2025.
    • However, in 2026 and 2027, the wage index will likely be recalculated starting from the original proposed reduction amount (more than 5%), not the capped 5% reduction.
    • This means it is very unlikely those hospices will see their wage index increase back up in 2026 and 2027.
    • The only way they may avoid further reductions in 2026 and 2027 is if the Medicare hospital cost report data shows a significant increase in wages from 2022 to 2023 in that geographic area.

Q: Are there any different requirements for pediatric hospices?

A: We have not seen any changes for pediatric hospices, specifically in this final rule. We continue to look out for any pediatric-related updates that may be included in other final rules, like last year’s Home Health final rule that had some changes impacting hospice. However, for this current hospice final rule, we have not identified any new requirements or changes specific to pediatric hospices. Contact our team directly through our website or our contactus@simitreehc.com if you want to check in on these updates. Remember, you can always call us at 800-949-0388 and we will put you in touch with an expert!

Q: How can SimiTree help with the financial changes due to the final rule?

A: One of the ways that SimiTree can help is with budgeting preparation for 2025 based on the financial changes from the final rule, specifically the changes in local CBSA wage indexes across the different markets where the hospice operates. Symmetry can also help with revenue forecasting and staffing analysis.

Q: What is the difference between the rate changes shown in slides 5 and 6 of the handout?

A: Slide 6 shows the final rule rate changes, which include a 2.9% increase, while slide 5 shows the proposed rate changes, which were 2.6%. So, there was a slight increase from the proposed to the final rule. (Access the handout/the full webinar slides using this link and find the webinar titled ‘Hospice Final Rule FY 2025: Key Takeaways and Financial Breakdown’ under the ‘Consulting’ tab.)

Q: Was the last COPs updated back in 2008 or are there new COPs for Hospice?

A: We recommend you pull the current Conditions of Participation on CMS’ website to ensure you have the most updated version. Some changes have been made throughout the years, such as the contents of the Election Statement. Ideally, save the webpage to your desktop or laptop for easy access whenever you need it.

Q: I heard push back from national groups that the timeframe of the CAHPS changes is too soon. Any update on this?

              A: We have not seen any updates on this concern as of today.

Q: Will standardized scales be published so that moderate and severe scores are reliable?

A: Currently, the tool specifies “based on clinical assessment”.  The options in the assessment component of the symptoms includes:

    1. Not at all – symptom does not affect the patient, including symptoms well-controlled with current treatment
    2. Slight
    3. Moderate
    4. Severe
    5. Not applicable (the patient is not experiencing the symptom)

Watch the Webinar On-Demand 

Missed the live session? No worries! You can watch the webinar on-demand by visiting our webinars page and locating it under the ‘Consulting’ section. 

Reach Out for Assistance 

We know that changes in regulations can create uncertainty and concern. If you have any questions or need personalized support regarding the Home Health Proposed Rule 2025, our team is here to help. Visit our contact page to submit a form for a meeting, and we can answer any questions you may have.  

We help with:

We are committed to helping your hospice team navigate these changes smoothly and effectively. Reach out to us to ensure your hospice agency is well-prepared and can continue to provide exceptional care. 

To keep reading, explore our comprehensive suite of services on our website, or contact us with any questions or concerns. We look forward to supporting your hospice agency through these regulatory changes. 

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