CMS has issued a new rule requiring hospice providers participating in Medicare to implement a quality assessment and improvement system, the Washington Post reports. The rule, set to take effect in December, mandates that hospices allow patients to help decide on treatment plans and demonstrate improvement in areas where they are found deficient, according to the Post. The data initially would be available to hospice organizations and Medicare, but providers and experts believe the data eventually will be shared with the public, similar to the way the federal government shares data on nursing homes, hospitals and home health agencies, according to the Post.

Approximately 1.3 million U.S. residents received hospice services in 2006, more than twice as many as in 1996. Medicare spent about $10 billion on hospice care -- which it provides to beneficiaries at no cost -- in 2007, compared with about $3 billion in 2000. However, advocates say hospice services are still underutilized. Malene Davis, president and CEO of Capital Hospice, said "widespread misconceptions," such as that hospice care is only for cancer patients, discourage many from seeking hospice care, the Post reports.

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Davis said the new rule will decrease variations in how care is delivered and eventually help consumers choose hospice providers that provide the best services.

Naomi Naierman, president and CEO of the American Hospice Foundation, said that until more uniform data are made public, "there is no way of choosing at this point or differentiating among hospices," and often "once you make a decision to go into hospice, there's really no recourse; it's a fairly final decision."

According to Judi Lund Person, vice president for regulatory and state leadership at the National Hospice and Palliative Care Organization, hospice providers are happy with the new rule. Lund Person noted that NHPCO already voluntarily tracks its performance and that many hospice providers use family surveys to evaluate themselves (Ault, Washington Post, 7/1).

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