Hospice Quality

Based on feedback from hospice leaders nationally, the fourth updated quality score calculation was uploaded 10/16/23. The most recent data update occurred 5/27/24, now including the 5/24 CMS Care Compare quality files.

Beginning 4/12/23, the National Hospice Locator provides free information to the public regarding every known hospice location - and it is now default sorted by quality. This is the first publicly available ranking of all hospices by quality, ever.

Hospice quality matters. Hospice quality is important, yet difficult to define, measure, or report. Hospice Analytics, with input from hospice leaders across the country, developed a hospice quality ranking tool. This is not unique - although ranking all hospices in the country and making that information freely available to the public has never been done before.

Currently seven (7) weighted metrics are used to calculate a hospice quality ranking score. Metrics are pulled from various Medicare files, detailed below. These metrics will be recalculated as new information becomes available. Ongoing discussion with hospice leaders allows for metrics to be added or removed, as well as weighted values to be changed, in the future. In the 4th update, hospice quality scores range from 35-100 out of a possible 100 points; mean and median scores ~67; and the 80th percentile score ~82 (i.e., if a hospice quality score >= 82, this is higher than 80% of the hospices in the country). Hospices with quality scores <50 are generally missing the information used to calculate a score. In 5/24, for the first time ever, two hospices achieved 100% of possible ranking points - congratulations Avow Hospice, FL, and Hospice of Miami County, OH.

The seven (7) current quality metrics include:

1. Hospice Visits in Last Days of Life, from the Hospice Item Set.
2. Staffing Ratios, from Hospice Claims.
3. Levels of Care, from Hospice Claims.
4. Definitely Recommend This Hospice, from the Hospice CAHPS.
5. Stability (years certified & change of ownership), from the CMS Provider of Service file.
6. Accreditation, from the CMS Provider of Service file.
7. Equity (any Medicaid), from Cost Reports.

Why now? The discussion of hospice quality has been occurring for decades. Ranking hospice quality and sharing that information publicly is not without risk - which is the primary reason no one has done it. However, in recent months, there has been a dramatic increase in the number of hospice providers and some critique of the hospice field. This has created confusion for the general public regarding how to choose a hospice provider. Hospice Analytics' mission is to increase access to and utilization of high-quality hospice service. We decided to create a tool to help the general public find high-quality hospices and integrate it into our existing National Hospice Locator. The time is now...

The National Hospice Locator was publicly launched in 2012 to help the general public find hospice providers in their area. It averages 12,000+ visits and searches / month. Until recently, the default sort was based on hospice census. The largest hospices were listed first - mostly due to the assumption that larger hospices had greater capacity for depth and breadth of services. However, the largest hospices may or may not have the highest quality - quality is a different dynamic. Therefore, beginning 4/12/23, the National Hospice Locator has changed how the default sort order of hospices listed - now based on a calculated quality score. Users may still sort search results by hospice size and other factors.

Please contact Hospice Analytics at Info@HospiceAnalytics.com with questions, suggestions, and feedback.

Hospice quality matters - and the time is now.