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Have a HEART assessment tool ... or not

Last year the Centers for Medicare and Medicaid Services (CMS) launched a pilot program known as Pilot A made up of 9 hospices. These hospices were tasked with using a proposed hospice assessment tool and providing feedback to CMS on what did and did not work. The plan at the time was to take the feedback from Pilot A, make revisions and then have Pilot B utilize the revised tool and provide more feedback. Pilot B was never launched due to the concerns and issues identified during Pilot A.

The main issue was that since an electronic medical record (EMR) vendor was never included on Pilot A, those hospices participating identified a gap in their ability to complete and manage to assessment tool electronically. Initially, CMS indicated Pilot B was simply delayed and likely to start in early 2019 with an EMR vendor on board.

On Wednesday June 12th, 2019, CMS held an open forum to discuss the progress and process for the proposed hospice assessment tool known currently as HEART. During the 60-minute call, listeners were provided updated information and the opportunity to ask questions. CMS stated that in May 2019 they began “information gathering “on developing a hospice assessment tool that included interviews of hospices, hospice experts as well as conducting research on assessment tool best practices. They further stated that the information gathering would continue throughout the summer.

Once completed, the revised tool would be both Alpha and Beta tested. Alpha testing is scheduled to begin in 2020 and will involve post testing analytics and revisions before Beta testing is initiated. Once the 2 phases have been completed the tool would need to be approved through rule making before being launched for hospice use.

CMS was very clear in their intent to be mindful of the impact on patient care and services with designing the tool as well as the time involved to complete the tool and upload it. The tool, which likely will have a name change, is meant to replace the current hospice item set (HIS) tool.

Currently, the assessment tool will be completed at admission, 60 days and upon discharge. CMS is contemplating increasing the frequency to as much as every 2 weeks or with every recertification period.

Later this summer, CMS plans to have open forums where hospices can offer suggestions about the tool and thoughts on the potential impact to their programs. When asked the expected date of launching the assessment tool, CMS was vague. Someone asked if it was between 12-24 months, but CMS stated that was too aggressive of a timeline at this point.

So what is the take away message from the session? Hospice will not likely see the assessment tool finalized until at the earliest, 2021. Hospices need to keep their eyes open for the opportunity to weigh in on the tool during the four proposed open forum sessions to further ensure that the impact of the tool is manageable, not time prohibitive and ultimately does not negatively impact patient care. Stay tuned.

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