Experts who advise Congress on Medicare policy are — once again — recommending no pay boost for skilled nursing facilities.
The Medicare Payment Advisory Commission met late last week to discuss whether SNFs and other sectors ought to get a raise. For skilled nursing, the group is recommending that Congress eliminate the fiscal 2020 update to Medicare base payment rates. Inpatient rehab facilities and home health agencies, meanwhile, were recommended to get a 5% reduction in payments.
Commissioners also endorsed revisions to the SNF prospective payment system for fiscal 2020 to recalibrate the relative weights of case mix groups to maintain alignment of payment and costs. Payments will be based on patient characteristics, including comorbidities, functional status, cognitive impairment and special services. The system would redistribute payments from high-therapy patients to those who are medically complex, according to presentation slides from the meeting.
The recommendations are preliminary — and non-binding for lawmakers. The commission plans to vote on them in January and a final report to Congress in March.
Commissioners said the proposed flat payment proposal for SNFs is based on the industry having adequate access to capital, Medicare margins of 11.2%, and, and a steady supply of skilled care beds. About 89% of Medicare beneficiaries live in a county with three-plus SNFs, the presentation noted.
