The Patient Protection and Affordable Care Act and Its Impact on Hospice


The health care reform bill signed into law by President Obama on March 23, 2010, otherwise known as the Patient Protection and Affordable Care Act (PPACA), will have a broad impact on virtually all aspects of health care, with hospice being no exception. Since the implementing regulations to the PPACA have not yet been published, we do not know the specifics of how we will be expected to achieve its new requirements. However, we do know what Congress intends the end results to be. The impact on hospice providers can be defined in terms of quality, data collection, accountability, payment reform and access to care. Some of the more significant provisions of the PPACA, as applied to hospices, are summarized below.


Various reports by the Office of Inspector General (OIG) and the Medicare Payment and Advisory Commission (MedPAC) over the last few years have found that it is difficult to assess quality among hospices because there are no uniform quality data requirements. The PPACA will address this issue by requiring hospices to report on quality measures to be determined by the Secretary for the Department of Health and Human Services (Secretary) or face a 2% point reduction in their market basket percentage increase. The Secretary must publish the quality measures no later than October 1, 2012, and the reporting would begin in Fiscal Year 2014. Quality measure data will be made available to the public after the reporting hospice has an opportunity to review the data. While we do not know what will be included as quality measures, we should consider that the PEACE Project and AIM Project, both funded by CMS, will be potential sources.

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