On April 27, CMS issued a proposed rule outlining proposed Fiscal Year (FY) 2019 Medicare payment updates and proposed quality program changes for Skilled Nursing Facilities (SNFs). CMS has proposed a 2.4% increase in SNF payment rates for FY 2019. Based on changes contained within this proposed rule, CMS indicates aggregate payments to SNFs will increase in FY 2019 by $850 million from payments in FY 2018. At the same time, the overall impact of the SNF Value-Based Purchasing (VBP) program is an estimated reduction of $211 million in aggregate payments to SNFs during FY 2019.

CMS has proposed minor changes to the Quality Reporting Program (QRB) VBP and asked for input on interoperability. Proposed rule details:

• Advancing My HealthEData: Request for Information from stakeholders
• Modernizing the SNF Prospective Payment System (PPS) Case-mix Classification System
• SNF Quality Reporting Program (QRP)
• SNF Value-Based Purchasing Program (VBP)
• Payment rate changes under SNF PPS

Read the AHCA summary for additional details.  A recording of the AHCA member webinar held on Monday, April 30 is available through ahcancalED with your member log-in (required). Please email educate@ahca.org with any questions about or issues accessing the recording. 

As mentioned during the webinar, you can view CMS’ SNF Patient Driven Payment Model resources and tools, including the grouper tool, here.

Additional Resources

• Proposed Rule: CMS will accept comments until June 26.
• CMS Fact Sheet
• CMS SNF PPS Webpage
• CMS SNF QRP Webpage
• IMPACT Act of 2014 Data Standardization & Cross Setting Measures
• CMS SNF VBP Program Webpage