Service and Spending Variation Index - Given the growing concern of fraud, waste, and abuse in hospice care, CMS has continued to monitor trends on a variety of metrics from hospice claims, including non-hospice spending during a hospice election.

CMS has seen non-hospice spending continue to rise in recent years. In response, CMS developed a service and spending variation index (SSVI), using metrics collected from claims data, that can signal potentially inappropriate utilization or concerns with quality of care or compliance. The SSVI uses a scoring system, with a higher score representing potential concerning hospice utilization and non-hospice spending.