CMS Proposes 1.4% Payment Increase for Skilled Nursing Facilities

Overall Medicare payments to skilled nursing facilities would increase by 1.4%, or $500 million, in fiscal year 2016 under a CMS proposed rule issued Wednesday, Modern Healthcare reports.

Background

According to Modern Healthcare, SNFs admit more than two million beneficiaries in the traditional Medicare program annually. There are more than 15,000 SNFs in the U.S. that treat beneficiaries.

SNFs between FY 2014 and FY 2015 received an overall payment increase of about 2%, or $750 million.

Details of Proposed Rule

The proposed rule also calls for the implementation of a value-based payment model for SNFs, with quality metrics affecting reimbursements beginning in FY 2018.

The FY 2018 payments would be based in part on performance on quality measures for beneficiaries admitted to SNFs between Oct. 1, 2016, and Dec. 31, 2016 (Dickson, Modern Healthcare, 4/15). The three proposed measures are related to:

• Beneficiaries' skin integrity and changes in skin integrity;
• Beneficiaries' cognitive function and functional status, as well as related changes; and
• The incidence of major falls (CMS fact sheet, 4/15).

CMS is accepting public comments on the proposed rule through June 15 (Modern Healthcare, 4/15).