AHA pushes for payment policies to benefit hospital-based skilled nursing facilities

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The government should adjust Medicare payment policies to better support the type of care provided in hospital-based skilled nursing facilities, the American Hospital Association urged in a recent letter to a top healthcare official.

The skilled nursing facility prospective payment system should take more account of non-therapy ancillary services, such as drugs and diagnostic X-rays, the AHA stated in its June 25 letter to Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner. The Medicare Payment Advisory Commission has recommended this change, the letter noted.

The SNF PPS system also should have a high-cost outlier payment adjustment, the hospital association stated. Such a provision is part of every other hospital and post-acute provider prospective payment system, and it would help providers care for “exceptionally high cost” patients without having to resort to high therapy volume to maintain margins, the AHA argued. The organization pushed for the legislative action that would allow CMS to make this change.

Such changes would help hospital-based SNFs, which “treat more medically complex patients, discharge patients with a much shorter length of stay, and use more ancillary services” than other skilled facilities, the letter stated. About 850 hospital-based SNFs are members of the AHA, according to the association.

Click here to access the complete document, which served as the AHA's official comment on the proposed rule for the fiscal year 2015 SNF prospective payment system.

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