Week 6 Assignment 1: Hospice Data and QA/PI

Week 6 Assignment 1: Hospice Data and QA/PI

Crystal J. Evans

Data related to bowel function, pain screening and assessment, anxiety levels, dyspnea screening and treatment, patient treatment preferences and patient beliefs and values are collected (Broyles, Li & Zheng, et.al., 2016, p. 2). However, other data pertaining to length of hospice care, setting of care, types of illness and treatments in those settings and reimbursement are also analyzed through a cost-quality lens for hospice patients. (Levin, 2016). Accordingly, the data provided can illuminate both positive and negative aspects of hospice care, provider roles, and hospice reimbursement (Broyles, et.al, 2016). After all, Broyles, et.al. (2016) and CMS are currently engaged within developing quality measures to assess types of visits and their frequency during hospice with a special dataset for the last seven days (p. 4). Accordingly, Broyles, et.al. (2016) illuminates how this data is absent from current quality and utilization measures. However, the quality measures previously detailed show little variance. As such, the data measured and assessed does little to assure quality Since 90% of hospice care using these quality measures are viewed as “High quality,: this does little to help consumers or even help Medicare determine the overall quality of hospice care provided by these entities (p. 4).

Whereas, variable stays characterize hospice and 80%are discharged from care due to death, data suggests that one-third of hospice live-discharges are initiated by patents or families because patients wither revoke hospice benefit or move out of the hospice area. Yet, some other indicators suggest that patients discharged near the need of hospice benefit could suggest hospice providers’ desires to avoid scrutiny and to avoid a greater number of hospice patients approaching the hospice care cap. After all, hospice is limited to six months of care. Yet, Levin (2015) also demonstrated that assisted living facilities that provide hospice care might have discovered ways to incentivize such care (p. 15). After all, Levin (2015) demonstrates how Medicare pays twice as much for hospice care in assisted living facilities as it does for hospice in any other setting. Moreover, data collected indicates that patients in assisted living for hospice care require less care and treatments than those in other settings. Given this observation, one might wonder how and why the assisted living facility and hospice care phenomenon captured by the data actually occurs. Indeed, it raises many questions about hospice quality and the need for measures or other data inclusions.

(Levin, 2015, p. 15).

References

Broyles, I., Li, Q., Zheng, T., Frank, J., Sherif, N., & Rokoske, F. (2016). The Emerging Picture of Quality of Care in Hospice. RTI International Brief, June 2016. Retrieved from https://www.rti.org/sites/default/files/rti_issue_brief_hospice_quality_care.pdf

Levinson, D.R. (2015). Medical incentives to provide care in assisted living facilities. Department of Health & Human Services. Retrieved from oig.hhs.gov/oei/reports/oei-02- 14-00070.pdf