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July 31, 2017 01:00 AM

CMS gives skilled-nursing, rehab facilities a $370 million raise

Virgil Dickson
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    The CMS has finalized proposals to give skilled-nursing facilities and inpatient rehabilitation facilities pay increases in 2018.

    The agency on Tuesday announced that skilled-nursing facilities will receive a $370 million increase in federal payments for 2018, representing a roughly 1% increase. This is much less than the $920 million payment hike skilled-nursing facilities got this year.

    A value-based payment program for skilled-nursing facilities is set to begin Oct. 1, 2018, which will evaluate the providers' readmission rates and other care indicators.

    In 2015, the last year full data are available, about 15,000 SNFs furnished 2.4 million Medicare-covered stays to 1.7 million fee-for-service beneficiaries, according to the Medicare Payment Advisory Commission. Medicare fee-for-service spending on SNF services was $29.8 billion that year.

    Medicare also announced it would pay rehabilitation facilities $75 million more per year, but that's $70 million less than what they recieved this year year.

    The CMS has finalized its plan to remove some claims data requirements on rehabilitation facilities.

    A 25% payment penalty for inpatient rehabilitation facilities that fail to submit Medicare Part A claims forms has been removed. The CMS said this past spring that the penalty is "no longer needed to encourage providers to submit data to the CMS" because submissions are no longer accepted if they lack another form.

    The CMS also finalized removing a data metric on whether patients can swallow on their own without supervision. The agency said it duplicated a provision passed last year that included swallowing and nutritional status.

    In 2015, Medicare spent $7.4 billion on fee-for-service inpatient rehabilitation facility care provided in about 1,180 such facilities nationwide, according to MedPAC. About 344,000 beneficiaries had more than 381,000 inpatient rehabilitation facility stays.

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