Aggregate payments to skilled-nursing facilities next year are expected to increase by $470 million, or about by 1.3%, compared with payments in 2013, according to estimates from the CMS. That's slightly below what the agency projected when it released its proposed rule in May, which had called for a 1.4% payment hike that the CMS had projected would increase payments to skilled nursing providers by about $500 million from current payment levels.
CMS to increase Medicare payments to SNFs, inpatient rehab facilities
The increase in the final rule is based on a 2.3% marketbasket update to SNFs, along with two 0.5 percentage point reductions. Those include one for a multifactor productivity adjustment that is required by law, and another to correct a forecast error. According to the CMS, the agency applies a forecast error correction when the difference between the actual and projected marketbasket percentage change for a given year exceeds the 0.5 percentage point threshold.
Starting next year, the CMS will rebase and revise the current SNF marketbasket—an index that incorporates the commonly used cost categories for routine SNF services—to reflect more current data. The CMS reports that the current SNF marketbasket is based on fiscal 2004 data, and the new one starting in 2014 will be based on data from fiscal 2010.
The American Health Care Association, which represents skilled-nursing facilities, was generally pleased with the final word on next year's payment and policy changes from the CMS.
“While AHCA voiced some concerns about CMS data analysis, overall, the skilled-nursing profession appreciates the agency's even-handed rule,” Mark Parkinson, president and CEO of AHCA, said in a written statement. “The marketbasket increase allows long term and post-acute care providers to focus on the important work of improving the lives of the seniors within their care.”
Meanwhile, the CMS estimates that aggregate payments to inpatient rehabilitation facilities will increase by about $170 million, or 2.3%, from current payment levels. Those estimates are a little higher than what the CMS estimated in its proposed rule this spring.
The inpatient rehabilitation center final rule kept a recommendation included in the proposed rule to add three new quality measures—flu vaccination coverage of healthcare personnel, tracking flu vaccination to patients, and an unplanned readmissions measure—to the IRF Quality Reporting Program.
The 2010 health reform law required the HHS secretary to implement a quality program for these facilities, and providers who don't submit required quality data will see a 2 percentage point reduction to their annual increase for payments starting in 2014.
Follow Jessica Zigmond on Twitter: @MHjzigmond
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