CMS: Medicare SNF reimbursements to rise by $500 million

Centers for Medicare & Medicaid Services ties each year's payment rate to the SNF market basket
Centers for Medicare & Medicaid Services ties each year's payment rate to the SNF market basket

Medicare would increase skilled nursing facility reimbursements by $500 million in 2016 under an updated payment rate proposed Wednesday.

The Centers for Medicare & Medicaid Services ties each year's payment rate to the SNF market basket, which represents the costs of goods and services needed to provide care when considering inflation. The 2016 rate would be a net 1.4% increase from fiscal 2015. It would derive from a 2.6% market basket update reduced by a pair of 0.6% required adjustments, CMS said.

As listed in The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, SNFs must soon begin submitting quality reports. Starting in two years, SNFs that do not submit quality data to CMS under the program will have their annual updates reduced by 2 percentage points.

Starting in fiscal 2018, as part of the quality reporting program, CMS has proposed to adopt three measures addressing quality: Skin integrity and changes in skin integrity; incidence of major falls; and functional status, cognitive function and changes in cognitive function.

CMS also proposed to adopt the Skilled Nursing Facility 30-Day All-Cause Readmission Measure, as the all-cause, all-condition readmission measure that will be used in of the SNF Value-Based Purchasing Program. CMS plans to propose more details on SNF value-based purchasing in its 2017 proposal. It is currently seeking comments on:

  • Performance standards
  • Measuring improvement
  • Appropriate baseline and performance periods
  • Performance scoring methodology
  • Public reporting of performance information
  • Feedback reports

Click here to see the latest on the proposed payment rule.