The Medicare Payment Advisory Commission is attempting again to stiff nursing homes while also eyeing quick action on payment system reform.
Commissioners, who advise Congress on Medicare policy on a non-binding basis, are recommending no pay boost for skilled nursing facilities for the coming fiscal year.
Their early December meeting boiled down to this for skilled nursing: Congress should eliminate the fiscal 2020 update to Medicare base payment rates. Other sectors would fare worse: Inpatient rehab facilities and home health agencies were recommended to get 5% reductions in payments.
Commissioners said the flat payment proposal for SNFs is based on the industry having adequate access to capital, Medicare margins of 11.2% and a steady supply of beds. About 89% of Medicare beneficiaries live in a county with three-plus SNFs, they noted.
Commissioners also endorsed revisions to the SNF prospective payment system for fiscal 2020. Payments would be based on patient characteristics, including comorbidities, functional status and cognitive impairment. The system would redistribute payments from high-therapy patients to those who are medically complex.
The recommendations were preliminary and non-binding, with the commission planning to vote on them in January.