CMS Proposes New Quality Reporting for Skilled Nursing Facilities
CMS pushes value-based care forward by proposing a new quality reporting rule for Medicare Skilled Nursing Facilities.
- CMS is hoping to bring more value-based care to skilled nursing facilities by issuing a proposed rule that raises the bar on quality reporting programs for these providers.
As part of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), skilled nursing facilities (SNFs) will be required to submit additional quality data or face a two percent reduction in Medicare payments. The proposed rule, known as CMS-1645-P, would add one new assessment-based quality measure and three claims-based measures to the IMPACT Act’s framework for SNF quality reporting.
The additional measures included in the proposal are aligned with those proposed for the Long Term Care Hospitals and Inpatient Rehabilitation quality reporting programs, and include an assessment-based measure addressing medication review and follow-up, as well as claims measures that focus on care coordination, spending, and preventable readmissions.
The rule would align skilled nursing facility quality reporting to the calendar year, with quarterly deadlines starting with the reporting period tied to reimbursements in 2019.
Last year, skilled nursing facilities were prompted to deliver value-based care after they were required to specifically report on three major areas of care quality starting in 2018. At that time, they will be required to report on incidence of major falls, skin integrity, and function, a previous report said.
The U.S. Department of Health & Human Services reached the goal of tying 30 percent of Medicare payments to care provided in alternative payment models ahead of schedule. The department is now moving forward with efforts to push 50 percent of payments for care provided in the form of alternative payments by the end of 2018. This factor has clearly led to payment and policy changes in skilled nursing facilities.
CMS is accepting comments and questions until June 20, 2016 for the new rule.
Based on proposed changes in this rule, CMS expects aggregate payments to skilled nursing facilities to increase by $800 million, or 2.1 percent, from 2016 to 2017 payments, CMS said in a press release.
The IMPACT Act also requires that skilled nursing facilities’ procedures for public reporting on quality, resources and other measures be consistent with Hospital Inpatient Quality Reporting processes.
CMS would like to see processes related to the review and correction of claims be based on measures that are aligned with Hospital Inpatient Quality Reporting processes.
