Feds propose payment bumps to SNFs, rehab hospitals and hospice providers

Skilled nursing facilities (SNFs), hospice providers and inpatient rehabilitation hospitals (IRFs) would all get payment bumps under proposed 2017 Centers for Medicare & Medicaid Services payment guidelines.

Altogether CMS plans to increase payments to those three types of providers by more than $1.2 billion in 2017.

SNFs will get the the biggest increase under the CMS proposal, 2.1 percent or $800 million in total. That includes a 2.6 percent market basked-based update, offset by a 0.5 efficiency reduction under the Affordable Care Act (ACA).

CMS would increase hospice payments by 2 percent or $330 million. The increase would include a 2.8 percent market basket update and 0.8 percent of reductions mandated by the ACA. 

IRFs would get the smallest bump, an increase of 1.6 percent or $125 million, under the CMS proposal. The pay bump includes a 2.7 percent market basket increase and a 0.2 percent jump for outlier cases, offset by ACA-mandated cuts of 1.25 percent.

CMS has also proposed changes to the quality reporting programs for all three providers, with a focus on patient safety concerns like patient falls and facility-acquired pressure ulcers, as well as changes to the value-based purchasing program for SNFs, which would include a new provision for improving the rates of readmissions to hospitals.

The Office of Inspector General of the Department of Health and Human Services has been pushing for such a metric for SNFs for years, claiming that such readmissions cost the Medicare program more than $14 billion a year.

Hospice payments have also come under scrutiny, as reimbursements for such services have risen five-fold since 2000. However, recently instituted reforms include the tapering off of payments after the first several months of care.

To learn more:
- read the CMS SNF payment proposal (.pdf)
- here's the IRF proposal (.pdf)
- check out the hospice proposal (.pdf)