Providers will have a say in how the Centers for Medicare & Medicaid Services recalibrates its Patient-Driven Payment Model, agency officials reiterated in a call with skilled nursing operators Thursday where they outlined their attempt to rein in spending.
Agency officials encouraged providers to submit suggestions for particular cost-cutting methods during a SNF/Long-Term Care Open Door Forum call, which came about a week after CMS unveiled its SNF Prospective Payment System proposed rule for next fiscal year. The rule included plans to recalibrate PDPM’s parity adjustment after the agency found aggregate SNF spending under the new model unintentionally increased by $1.7 billion.
Officials have previously acknowledged the increase could have been driven by the ongoing COVID-19 public health emergency and specifically called on providers to consider the pandemic’s impact on the PDPM adjustment.
“In this proposed rule, we solicit comments on potential methodology for comments for recalibrating the PDPM parity adjustment that we believe fully accounts for the potential effects of the COVID-19 PHE and provides a path for ensuring that PDPM achieves the intended goal of a budget neutral implementation going forward,” a CMS staffer said.
“We specifically seek comments on whether we should delay or phase in the adjustment once we’ve determined the appropriate methodology for recalibrating the PDPM parity adjustment,” the staffer later added.
Long-term care stakeholders have warned against a recalibration to PDPM, with one expert predicting the change could reduce SNF reimbursement by $12 per day.
The comment period for the proposed rule is open through June 7. CMS will announce any adjustments to the rule after collecting and making decisions about comments gathered.
