CMS Rebases Non-Routine Levels of Care in FY2020
On the Friday afternoon before Easter weekend, CMS dropped a bombshell. In its proposed rule for fiscal year 2020, it lays out an update to the hospice reimbursement rates that would increase all non-routine levels of care significantly. In order to make the change budget-neutral, this means CMS would reduce the scheduled increase to Routine Home Care rates to keep them essentially flat from FY2019 to FY 2020.
The current Base Rates for FY2019 are now:
Routine Home Care days 1-60: $196
Routine Home Care days 61+: $154
General Inpatient Care: $758
Inpatient Respite Care: $176
Continuous Home Care: $997 (daily max)
The new Base Rates for FY2020 as proposed would look like this:
Routine Home Care days 1-60: $195.65
Routine Home Care days 61+: $154.63
General Inpatient Care: $1,027.43
Inpatient Respite Care: $449.78
Continuous Home Care: $1,027.43 (daily max)
The rebasing increases GIP payment by more than 30% and Inpatient Respite by more than 100%. The trade-off of course, is that hospices will not receive the full anticipated increase of 2.7% to the Routine levels of care so CMS can keep the change budget neutral.
For hospices that currently provide little or no care at the non-routine levels, this is unadulterated bad news. However, for the average freestanding nonprofit hospice, CMS believes this will have a positive effect of an overall 4.2% increase in revenue. For hospices operating dedicated hospice facilities, I believe the impact may be far better than that.
I encourage everyone to model the effects of this proposed change on your finances, but I’m optimistic that this may be some very welcome good news for my clients operating hospice houses and IPUs.
You can read the press release announcing the proposed change on the CMS newsroom site. The full text of the proposed rule is available here, and also includes significant changes in quality reporting and wage index update schedules. CMS is requesting comment on the proposed changes through June 18, 2019.