Caryn Adams

I want to extend a very special thank-you to Pat Boyer.  She has been a longtime high-level contributor in our industry, and a fantastic mentor and friend. I am pleased for the opportunity to succeed her here and wish her well as she transitions to retirement.

Q: I did not receive an incentive payment for FY 2018 through the Skilled Nursing Facility Value Based Purchasing program. How can I ensure I receive incentives for FY 2019?

A: The SNF VBP program is an incentive payment program to reward facilities with a higher performance score for the 30-day all cause readmission measure. 

The performance score is the higher of your achievement or improvement score. The achievement score is your facility’s performance rate for a performance period against all SNFs in the baseline period — CY 2015, and the improvement score compares your facility’s performance during the performance period to your performance during the baseline period.

For FY 2019, the performance period is calendar year 2017.  The facility should be receiving quarterly and annual performance reports to show how it is doing with this claims-based measure. 

There are opportunities to correct data if it is incorrect and that date should be included in the letter.  This letter can be found in the QIES/CASPER system. 

To improve your odds of being in the top facilities receiving incentive payments, it is important to monitor your re-hospitalization rates. This applies only to Medicare FFS. 

This is a project for your QAPI program! For every resident who is readmitted to the hospital, perform a root cause analysis on the reason for the transfer and what could have been done to prevent it. 

Please send your payment-related questions to Caryn Adams at [email protected].