SNF performance beginning October 1, 2023 will directly determine Medicare Part A reimbursement rates starting in FY 2026, making immediate operational attention essential..
This final rule updates payment rates, including implementing the second phase of the Patient Driven Payment Model (PDPM) parity adjustment recalibration. This final rule also updates the diagnosis code mappings used under PDPM, the SNF Quality Reporting Program (QRP), and the SNF Value-Based Purchasing (VBP) Program.
Centers for Medicare & Medicaid Services. “Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2024.” Federal Register, vol. 88, no. 150, 7 Aug. 2023, p. 53200. www.federalregister.gov/documents/2023/08/07/2023-16249/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities.
Prepare Now: New SNF VBP Measures will Determine Future Medicare Reimbursements
New CMS skilled nursing facility value based purchasing (SNF VBP) measures take effect October 1, 2023 that will determine Medicare Part A rates beginning October 1, 2025. It is imperative that administrators, DONs, finance, QAPI and operations leaders be familiar with these new measures and understand how they will impact future reimbursement rates.
— AHCA/NCAL, August 29, 2023
CMS finalizes 4 percent pay raise, keeps contested turnover measure
Nursing homes will get a higher-than-expected 4.0% increase in their Medicare Part A payments in fiscal 2024, per a finalized Centers for Medicare & Medicaid Services rule publicized late Monday.
But major provider organizations immediately called the extra 0.3% too little to offset increasing costs, especially those likely to blossom from an expected federal staffing minimum.
— McKnight’s Long-Term Care News, August 1, 2023
CMS Finalizes and Proposes Slew of VBP Measures Connected to Quality, Staffing, Falls, Discharges
Skilled nursing facilities can expect three finalized measures, along with several proposed measures for future years related to the value-based purchasing program, the Centers for Medicare & Medicaid Services (CMS) officials said Wednesday.
The various measures include stipulations connected to quality, staffing turnover, resident falls and discharges.
— Skilled Nursing News, May 24, 2023
Feds’ value-based changes present ‘long overdue’ opening for SNFs
Payment and quality experts on Wednesday described extensive changes proposed for skilled nursing’s value-based purchasing program as “long overdue” and a way to “reset the playing field.”
In addition to updating the 30-day all-cause readmission measure, proposed new measures would account for operators’ performance on metrics related to nurse staffing turnover, discharge function, hospitalizations of long-stay residents and falls. Performance data would be phased in depending on the measure starting as early as FY2024, with incentives for some measures available as soon as FY2026.
— McKnight’s Long-Term Care News, April 6, 2023
CMS proposes 3.7 percent nursing homes pay boost; no details on staffing minimum
The Centers for Medicare & Medicaid Services Tuesday proposed a 3.7% pay hike for nursing homes but declined to issue a staffing minimum as part of its annual payment rule proposal. The agency said it “remains committed” to doing so “later this spring.”
“CMS continues to review the feedback and evidence from both the comment solicitation and mixed-methods study, all of which will be used to inform proposals for minimum direct care staffing requirements in nursing homes in rulemaking this spring,” the agency said Tuesday.
— McKnight’s Long-Term Care News, April 4, 2023
