Skilled nursing
facilities could get an $887 million increase in aggregate payments in fiscal
2020 under a proposed rule issued by the Centers for Medicare & Medicaid
Services (CMS) on Friday.
CMS issued a proposed
rule that would update the Medicare payment rates and quality programs for SNFs
as part of its effort to more closely align payments to the cost of providing
care, the agency said in its release.
For fiscal 2020, the
agency projects an increase of $887 million, or 2.5%, in aggregate payments to
SNFs, due to a 3% market basket increase factor, alongside a 0.5 percentage
point reduction for multifactor productivity adjustment.
The market basket rate
is set by the CMS Office of the Actuary, which considers the costs of various
products and commodities. Individual market baskets are produced for several
payment systems, including the Skilled Nursing Facility Prospective Payment
System (PPS), to measure the price changes providers are dealing with, according to CMS.
The market basket rate
was a bone of contention for providers last
year, prior to the announcement of the Patient-Driven Payment Model, when the
government’s spending plan set the rate at 2.4% for fiscal 2019.
The nation’s largest
SNF industry trade group, the American Health Care Association (AHCA),
applauded the proposed 2020 market basket increase.
“We are transitioning
to a new payment system, and the sector is on the financial brink,” AHCA
president and CEO Mark Parkinson said in a statement issued Friday. “MedPAC
just reported that our all-in margin is only 0.5 percent, and many skilled
nursing providers are facing devastating closures, particularly in rural areas.
This increase doesn’t solve these problems, but it gets us headed in the right
direction.”
CMS on Friday also
proposed changes to the value-based purchasing program (VBP) and quality
reporting program. The VBP initiative changes include scoring and operational
updates; updated public reporting requirements for SNFs to ensure CMS has
accurate performance information for low-volume SNFs; and a 30-day deadline for
Phase One Review and Corrections requests.
For the quality
reporting program, CMS proposed two new quality measures to assess the sharing
of health information; the transfer of health information from a SNF to another
provider; and the transfer of health information from the SNF to the patient.
It also proposed adopting several patient assessment data elements and updates
to specifications for the Discharge to Community PAC SNF QRP measure.
“In response to public
input, we are proposing to collect standardized patient assessment data and
other data required to calculate quality measures using the MDS on all
patients, regardless of payer source,” the agency noted.
Stakeholders have
until June 18 to submit any commentary on the proposals, which are described in full in the Federal
Register.
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