CMS proposes modest FY 2016 payment hike for rehab hospitals

The Centers for Medicare & Medicaid Services has issued a new proposed payment hike for inpatient rehabilitation facilities for the 2016 fiscal year.

The net payment hike would be 1.7 percent, which is smaller than it has been in recent years. The increase would represent additional revenues of about $130 million. It also includes a market basket increase of  2.7 percent, offset by a cut related to improved productivity of 0.6 percent, another 0.2 percent cut mandated under the Affordable Care Act, and an additional 0.2 percent cut to take into account outlier cases.

And, after the 2016 fiscal year, CMS also proposes to replace the current market basket calculations, which are part of the rehabilitation, psychiatric and long-term care market basket, with data specific to freestanding and hospital-based inpatient rehabilitation facilities. CMS noted that under the current methodology, cost differences between hospital-based and standalone facilities are not properly accounted for.  

"The most significant differences occurred for salary and pharmaceutical costs. Specifically, the hospital-based IRF salary cost shares tend to be lower than those of freestanding IRFs while hospital-based IRF pharmaceutical cost shares tend to be higher than those of freestanding IRFs,"  CMS said in its proposal.

CMS has also recommended implementing several quality measures to guage the performance of the facilities, including measures tied to skin integrity, the patient's functional status and injuries that are linked to in-facility falls.

Rehabilitation facilities have come under greater scrutiny for the quality of care they provide, particularly after a study published last year suggested that more than 10 percent of all patients discharged from rehabilitation facilities are admitted for inpatient acute care services within 30 days.

To learn more:
- here's the CMS proposal (.pdf)