The CMS threshold, why hospices trip it, and what to change — starting this week.
Status: proposed, not final. These scores come from the SSVI file CMS published with the FY2027 Hospice Wage Index proposed rule (CMS-1851-P, April 2026). CMS is explicit that the SSVI is not a finding of fraud, waste, or abuse — it flags claims patterns that may warrant additional oversight.
24.7% of scored hospices nationally tripped this measure in FY2025.
This measure is the share of all discharges — live or dead — where the patient left hospice alive, whether through revocation, becoming no-longer-terminal, or transfer to another hospice. A hospice at or above the 75th percentile nationally gets flagged. High live discharge rates are one of CMS’s clearest proxies for admissions that were never well-supported.
Percentile-based thresholds are recalculated by CMS every fiscal year, so the line moves as the industry moves.
The national median sits well below the flag line, but there is no single target number to chase — the goal is defensible admissions, and a low rate is simply a byproduct of getting eligibility right.
Yes — a transfer shows up as a live discharge on your claims for this measure, even though the patient remained in a hospice election.
Look up your score free — the breakdown shows your raw value on this exact measure next to the CMS threshold. Or browse scores by state.
Friday, July 17 · 40 minutes · Hosted by Miles Pickens, Hospice Engine
Bring your score. We’ll walk through what’s driving it — spending, utilization flags, percentile rank — and what to change first. Zoom link sent by email when you register. The first 3 seats each Friday are free.
The Friday SSVI Q&A is free for the first 3 seats. For agency-specific work, book an SSVI consultation.