payment increase for SNFs

Proposed payment increase for SNFs

SNFs could see a 2.1 percent increase in Medicare payments for fiscal year 2017, according to a new proposal from the Centers for Medicare & Medicaid Services (CMS). The proposed rule, which was announced in late April, is projected to be finalized by late summer in order to take effect for the next fiscal year, which begins on October 1. The new rate would be an increase from the previous year’s payment bump, which was just 1.2 percent.

Other new items announced in the rule include:

  • A value-based purchasing program. Set to begin in 2019, the program would create value- and performance-based incentive payments.
  • Four new measures of quality and resource use:
    • Three claims-based measures: discharge to community; Medicare spending per beneficiary; and potentially preventable 30-day post-discharge readmission rates
    • One new assessment based measure: drug regimen reviews

In its announcement of the changes, CMS reiterated their importance in the transition toward value-based reimbursements. “The Administration has set measurable goals and a timeline to move the Medicare program, and the health care system at large, toward paying providers based on the quality, rather than the quantity of care they provide to their patients,” the agency said. “The Administration met the goal of tying 30% of Medicare payments to care provided in alternative payment models ahead of schedule and is continuing this momentum to reach the goal of tying 50 percent of payments to care provided in alternative payment models by the end of 2018.”

While the payment boost is welcome news to SNFs, organizations will still need to keep a close eye on Medicare revenue. Research conducted by ABILITY has found that monitoring Medicare claims is one of the top challenges for billers and billing managers, given the time-consuming steps of working in the DDE/FISS system. Many facilities have successfully automated some of these processes with software, which frees up billers’ time to work on other claims and higher-level projects.

As CMS continues to challenge SNFs to provide more reporting and quality measures, facilities will need to ensure they’re leveraging staff time wisely. Putting plans in place now will set the stage for success in the next fiscal year.