The federal government’s reimbursement shift from volume to value would continue with proposed changes to fiscal year (FY) 2016 Medicare payment rates for skilled nursing facilities (SNFs) announced by the Centers for Medicare & Medicaid Services (CMS). They appear in the April 20 Federal Register. CMS is accepting e-mailed, mailed or hand-delivered comments until 5 p.m. June 19.
“Based on proposed changes contained within this rule, CMS projects that aggregate payments to SNFs will increase by $500 million, or 1.4 percent, from payments in FY 2015,” CMS stated in an April 15 fact sheet posted on its website. The net increase, according to the agency, would result from a 2.6 percent market basket increase that would be reduced by a 0.6 percentage point forecast error adjustment and then reduced again by a 0.6 percentage point according to the multifactor productivity adjustment required by law.
The proposed rule also addresses quality reporting, value-based purchasing and staffing data collection.
Quality reporting. Under the IMPACT Act passed in September, SNFs that do not submit required quality data to CMS beginning in FY 2018 would see their annual updates reduced by 2 percentage points. Under the proposed rule, CMS would adopt three measures—related to skin integrity, major falls, and functional status and cognitive function—to address three quality domains identified in the act.
Value-based purchasing. The proposed rule would adopt the SNF 30-Day All-Cause Readmission Measure, which estimates the risk-standardized rate of all-cause, unplanned hospital readmissions for SNF Medicare beneficiaries within 30 days of their prior proximal short-stay acute hospital discharge.
CMS is seeking comments on the following for FY 2017:
- Performance standards;
- Measuring improvement;
- Appropriate baseline and performance periods;
- Performance scoring methodology;
- Public reporting of performance information; and
- Feedback reports.
Staffing data collection. CMS proposes that, beginning July 1, 2016, long-term care facilities that participate in Medicare or Medicaid be required to electronically submit direct care staffing information (including information for agency and contract staff) based on payroll and other verifiable and auditable data in a uniform format.