The Centers for Medicare & Medicaid Services (CMS) launched Hospice Compare, a consumer-focused website. It allows families to compare about three hospice agencies at a time, among 3,876 nationwide and the site aims to improve transparency and empower families to “take ownership of their health,” at hospitals and nursing homes, according to a press release.
The website allows families to see how hospices performed in seven categories, including the screening for pain and breathing difficulties and how many patients on opioids were offered treatment for constipation. The experts found that self-reported quality assessments of hospices were not helpful as about three-quarters of hospices scored at least 91% out of 100 on six of the seven categories, reported in the journal Health Affairs.
“The Hospice Compare grades were based on hospices reporting whether they followed a specific process, such as screening for pain when the patient arrives, which allows just superficial assessment. Hence the scores may not to be helpful for patients or for quality improvement”, said Dr. Joan Teno and the other authors.
Meanwhile, troubling variation in hospice quality was investigated in Teno’s research. He measured by how often hospice staff visit a patient when death is imminent. “It's nice that they're at least beginning to be concerned about hospice quality,” said Dr. Joanne Lynn, researcher, but currently it’s of limited value.
The author reported that people who choose hospice are better benefited, as it provides other information such as the average caseload for hospice staff; Percentage of patients discharged alive; whether hospice significantly serves nursing home patients or offers resources to at-home care.
The Hospice Compare website does include federal regulations: Inspection reports are not part of the website, as they are for nursing homes. Current hospice inspection reports are hard to find as according to a federal rule, hospices can remain uninspected for a period of 6 years. But by 2018, CMS requires the reports to be reviewed once in 3 years.
Quality measures such as mortality rates for hospitals and nursing homes, don’t translate well to the hospice setting, Lynn noted. Lynn said that Hospice Compare is “skeletal” at the moment however it allows families to get details of the hospices, such as the nearby hospices and their phone number. “I'm hoping that it continues to improve over time,” as CMS’ other consumer-focused websites have, she continued.
In forthcoming year, CMS plans to add family ratings of hospices, including how timely hospice staffs were when a patient required help. They are gathering data on how often hospice staff visits a patient when death is imminent, which should be made public in late 2018, a CMS spokesperson said.