After LeadingAge and their industry partners went through tremendous efforts to educate CMS on the reality of implementing the proposed Special Focus Program (SFP) as proposed in the CY2024 Home Health Rule, CMS has decided to move forward with what was initially proposed.
- CMS is finalizing the inclusion of CAHPS Hospice Survey data in the SFP algorithm as proposed, which includes using four CAHPS Hospice Survey measures to create the Hospice CAHPS Index, standardizing the CAHPS Index, double weighting the CAHPS Index in the algorithm, and using two versions of the algorithm to address missing CAHPS Hospice Survey data.
- CMS is finalizing without modification the inclusion of the HCI score, the standardization of the HCI score, and how missing HCI scores are handled in the SFP algorithm, specifically by replacing a hospice’s missing score with zero after standardization which is equivalent to replacing it with the average value.
- CMS is finalizing the inclusion of unscaled Condition Level Deficiencies and unscaled substantiated complaints from three consecutive years of data, the standardization of both inputs, and replacing a hospice’s missing CLDs or substantiated complaints with zero after standardization which is equivalent to replacing it with the average value in the SFP algorithm as proposed.
Additionally, CMS plans to select the poorest performing hospices, from the 10 percent selectee list based on the finalized SFP algorithm score, in sequential value. This selection process will not include hospices already in the SFP or on a correction track. The industry had asked for a preview period in advance of implementing the SFP algorithm, however CMS believes further delay would likely impact patient and family health and safety. CMS added, hospices are aware of their status for each element used in the algorithm and have had opportunities to preview these elements prior to the use in the algorithm. Read a joint statement from the hospice industry associations here.
