Money, Healthcare

Nursing home operators are in line to receive an aggregate $784 million Medicare boost next year, if a federal proposal released Friday remains unchanged. It would amount to a 2.3% net increase starting Oct. 1, 2020, the start of the 2021 fiscal year.

“With an all-in margin of -0.3 percent, there are still real challenges for skilled nursing providers. However, this increase gets us headed in the right direction,” said Mark Parkinson, president and CEO of the American Health Care Association in a statement. 

A CMS fact sheet on the proposals can be found here, while the proposed rule itself can be found here. CMS will be taking comments on the proposals until June 9.

The proposed pay rate increase is 2.7% for the market basket update, but that is to be offset by a 0.4% reduction for multifactor productivity adjustment.

CMS also said it wants to apply a 5% cap to wage index increases. That will be informed by revised geographic delineations used to identify a provider’s status as an urban or rural facility. 

ICD-10 code mapping also would be changed slightly under the Patient Driven Payment Model, the agency said in announcing the proposals late Friday afternoon.

In addition, the rule includes minor administrative proposals related to the SNF Value-Based Purchasing Program, the agency said. Specifically, CMS hopes to align text with previously finalized policies in order to apply the 30-day Phase One Review and Correction deadline to the baseline period quality measure quarterly report, “and to establish performance periods and performance standards for upcoming program years.”

The agency is not proposing any changes to the measures, SNF VBP scoring policies or payment policies.