CMS dumps litany of Medicare payment changes for skilled-nursing facilities, rehab, hospice care
- CMS, in a flurry of announcements late Thursday afternoon, released proposed Medicare payment increases to inpatient rehabilitation facilities, skilled-nursing facilities, and hospice care.
- The agency projected aggregate payments to skilled-nursing facilities will increase 2.1%, or $800 million, next year based on the proposed changes.
- Two new hospice quality measures were proposed: a measure to assess hospice staff visits to patients and caregivers in the last week of life, and a measure to assess the percentage of hospice patients who received care processes consistent with guidelines.
For inpatient rehabilitation facilities, the agency proposed an overall update of 1.6%, or $125 million, compared to payments in fiscal 2016.
Hospices would see a 2%, or $330 million, increase for fiscal 2017 payments.
CMS twisted the dial more toward value-based care in the new Medicare payment rates for skilled-nursing facilities. The proposed rates finalized the creation of the SNF Value-Based Purchasing Program beginning with fiscal 2019 under which value-based incentive payments are made to SNFs based on performance.
"This rule proposes to specify the SNF 30-Day Potentially Preventable Readmission Measure, (SNFPPR), as the all-cause, all-condition risk-adjusted potentially preventable hospital readmission measure," the agency stated in a fact sheet.
"The SNFPPR assesses the facility-level risk-standardized rate of unplanned, potentially preventable hospital readmissions for SNF patients within 30 days of discharge from a prior admission to a hospital paid under the IPPS, a critical-access hospital, or a psychiatric hospital."
The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT) requires a quality-reporting program for skilled-nursing facilities to be implemented at the beginning of fiscal 2018. The measure also states that such facilities that do not submit quality data to CMS under the SNF Quality-Reporting Program will be subject to a 2% reduction to annual rate updates.
To help satisfy IMPACT requirements, CMS proposed a new assessment-based quality measure - drug regimen review conducted with follow-up for identified issues - and three claims-based measures:
- Discharge to Community – Post Acute Care (PAC) SNF QRP;
- Medicare Spending Per Beneficiary (MSPB) – PAC SNF QRP;
- Potentially Preventable 30 Day Post-Discharge Readmission Measure for SNFs.
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