The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service prospective payment system for skilled nursing facilities (SNFs) for fiscal year (FY) 2023. Highlights of the proposed rule include:
- A 4% net increase in the federal per diem rate after the marketbasket update and other adjustments. SNFs that fail to comply with CMS quality reporting program (QRP) requirements are subject to a 2 percentage point reduction to the federal rate update.
- A 4.6% “parity adjustment” cut to maintain budget neutrality following implementation of the new Patient Driven Payment Model.
- Adopting one new quality measure in the SNF QRP beginning with the FY 2025 SNF QRP, the Influenza Vaccination Coverage among Healthcare Personnel (NQF # 0431) measure.
- Resuming the reporting of certain measures and patient data that were delayed due to the COVID-19 public health emergency (PHE) beginning Oct. 1, 2023.
- Revising the compliance date for the Transfer of Health Information measures and certain standardized patient assessment data elements that were delayed due to the PHE
- Updating the SNF value-based purchasing (VBP) program, including continued suppression of the SNF 30-day all-cause readmission measure for the FY 2023 SNF VBP program year for scoring and payment adjustment purposes.
- Adding two new measures to the SNF VBP program starting with FYs 2026 and 2027.
- Seeking information on revising the requirements for long term-care facilities to establish mandatory minimum staffing levels.
- Establishing a permanent policy to smooth the impact of year-to-year changes in SNF payments related to changes in the wage index, ensuring that each provider’s wage index is at least 95% of its prior year wage index.
- Implementing a slight increase in the labor-related share of the federal rate from the current 70.4% to 70.7%, which will result in a slight payment increase for SNFs with a wage index greater than 1.0.
- Seeking comments on three topics:
- Quality measures for future years of the SNF QRP.
- The inclusion of CoreQ: Short Stay Discharge Measure in the SNF QRP, which would calculate the percentage of individuals discharged in a six-month period who are satisfied with their SNF stay.
- Strategies to improve measurement of disparities in healthcare outcomes and the agency’s framework to collect, stratify and report quality performance data across the CMS programs, including the SNF QRP.
Comments are due June 10 and should be submitted electronically. The MHA with provide members with an estimated impact analysis and additional detail on the proposed rule within the next few weeks. Members with questions should contact Vickie Kunz at the MHA.