CMS proposes 1.3% pay increase — with plenty of strings attached – News – McKnight’s Long Term Care News – McKnight’s Long Term Care News

A proposal that would boost Medicare payments to skilled nursing providers by 1.3% next fiscal year also could trigger additional reporting requirements and increase the potential for penalties.

Adjustments to the SNF Quality Reporting Program and the SNF Value-Based Program were wrapped into an updated Skilled Nursing Facility Prospective Payment System announced late Thursday afternoon by the Centers for Medicare & Medicaid Services.

The proposed rule would net providers an additional $444 million in overall Medicare Part A payments, a boost that comes as many providers say they’re operating at a loss due to the ongoing pandemic.

But CMS acknowledged the aggregate amount did not incorporate SNF VBP reductions estimated at $184.25 million for FY 2022. The agency is also pledging future adjustments to the Patient-Driven Payment Model to balance out a perceived but unintended increase in payments. 

And the proposal makes clear CMS is pursuing plans to expand programs that tie pay to performance, such as VBP and QRP.

The CMS administrator can expand the VBP program to as many as 10 measures beginning in FY 2024, thanks to a provision in the Consolidated Appropriations Act of 2021. Those future reporting requirements can measure functional status, patient safety, care coordination or patient experience, and the agency said Thursday it is specifically seeking comments on how best to capture resident impressions and staff turnover data. 

Some data elements already mandated for reporting by both SNFs and long-term care facilities could be in the running, as the agency attempts to increase pay parity.