Assess the Impact of Proposed Changes in the Hospice Rate on Your Organization
Tuesday, May 5, 2015
by: Visiting Nurse Associations of America

Section: Quality and Educational Programming

In order to inform VNAA's comments, we seek input on the impact of the different payment models considered by CMS on your agency. VNAA member Patrick Brown from Penn Home Care and Hospice Services has created this tool to assist members in your analysis. We ask that members use this tool to assess the various models on your agency and share your results with VNAA by emailing Molly Smith at Please note that the model does not include the Severity Add-On (SIA) payment that CMS proposed in the rule. This payment is intended to provide additional reimbursement for hospices that have RNs or social workers provide services to patients in their homes in the last seven days of life. Therefore, your reimbursement may be higher under the CMS model than the tool will currently calculate.

How to use this tool:

  • Use Tab 1 to collect the data necessary to calculate the impact of the different payment models.
    • Identify patients by length of stay and then categorize them into one of three groupings: 1) patients who died while in hospice and had a visit in the last two days, 2) patients who died while in hospice and did not have a visit in the last two days; and 3) patients who were discharged alive from the program.
    • The model includes lines for patients who stay up to 120 days.
    • Enter patients (and the number of days the patient was on program) who stay longer than 120 days in the colored sections below. The color code is:
      • Orange: patients who died with a visit
      • Yellow: patients who died without a visit
      • Green: patients who were discharged
  • The model will automatically update the calculations in the subsequent tabs. The summary tab will give an overview of how reimbursement may change for your agency under each model.

Please contact Molly Smith ( with any questions.

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