CMS Final Rule for SNFs, Fiscal Year 2017

CMS recently published a Final Rule which outlines fiscal year (FY) 2017 Medicare payment policies and rates for the Skilled Nursing Facility Prospective Payment System (SNF PPS), the SNF Quality Reporting Program (SNF QRP), and the SNF Value-Based Purchasing (SNF VBP) Program. 

SNF PPS

• CMS projects that aggregate payments to SNFs will increase in FY 2017 by $920 million, or 2.4 %, from payments in FY 2016. This estimated increase is attributable to a 2.7 % market basket increase reduced by 0.3 percentage points, in accordance with the multifactor productivity adjustment required by law. 

SNF VBP

• The SNF VBP Program applies to freestanding SNFs, SNFs affiliated with acute care facilities, and all non-CAH swing-bed rural hospitals.
• The final rule implements requirements for the SNFVBP including performance standards; scoring methodology, and a review and correction process for performance information to be made public.
• The VBP measures will apply to payments for services furnished on or after 10/1/18; data collection will begin 10/1/16. 

All-Condition Risk-Adjusted Potentially Preventable Hospital Readmission Measure (SNFPPR)

• The already final ‘SNF 30-Day All-Cause Readmission Measure (SNFRM) will be replaced “as soon as Practicable” by the All-Condition Risk-Adjusted Potentially Preventable Hospital Readmission Measure (SNFPPR) specified in this final rule. 
• The SNF-PPR assesses the facility-level risk-standardized rate of unplanned, potentially preventable hospital readmissions for SNF patients within 30 days of discharge from a prior admission to a hospital paid under the Inpatient Prospective Payment System (IPPS); a critical access hospital; or a psychiatric hospital. 
• The SNFPPR is claims-based, requiring no additional data collection or submission from SNFs.

SNF Quality Reporting Program (QRP)

CMS finalized 1 new assessment-based quality measure and 3 resource use claims-based measures:  

• Assessment:  1 QM to meet the Medication Reconciliation domain: 
• Resource Use Measures:  CMS adopted 3 measures to meet the IMPACT Act mandated resource use and other measure domains:
  • Medicare Spending per Beneficiary—Post-Acute Care SNF QRP (FY 2018);
  • Discharge to Community—Post Acute Care SNF QRP (2018);
  • Potentially Preventable 30-Day Post-Discharge Readmission Measure – SNF QRP (2018).  

Learn more about this Final Rule and upcoming CMS Quality Measures.