CMS boosts skilled nursing payment, saves providers money over next decade

The Centers for Medicare & Medicaid Services (CMS) on Friday unveiled a new proposed model for skilled nursing reimbursements that the agency says will save providers $2 billion over the next decade, according to Skilled Nursing News.

The proposed Resident Classification System, Version I (RCS-I) is out, and the Patient Driven Payment Model (PDPM) is in, with an effective start date of October 1, 2019.

“The proposed new model is designed to improve the incentives to treat the needs of the whole patient, instead of focusing on the volume of services the patient receives, which requires substantial paperwork to track over time,” CMS wrote in the announcement of the new scheme.

CMS framed the move as a concession to providers based on feedback regarding RCS-I, pointing out that the PDPM has an 80% reduction in payment group combinations as compared to the initial plan and would slash reporting requirements, potentially saving providers $2 billion per year.

Like RCS-I, the PDPM would shift incentives away from providing hours of service and toward “clinically relevant factors,” with a goal of moving toward a single payment system for post-acute care.

Read more on this new plan at Skilled Nursing News.


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