On April 19, 2019, CMS released the Proposed Fiscal Year 2020 Payment and Policy Changes for Medicare Skilled Nursing Facilities. With this release, updates are proposed to SNF Prospective Payment System (PPS), SNF Value-Based Purchasing Program (VBP), and SNF Quality Reporting Program (QRP) and align with CMS’s efforts to shift Medicare payments from volume to value.
THE FOLLOWING CHANGES ARE NOTED IN THE PROPOSED RULE
Increase in SNF payments by $887 million, or 2.5 percent for fiscal year 2020. The updates to the urban and rural base rates under PDPM are as follows:
Establishing a subregulatory process for making nonsubstantive changes to the list of ICD-10 codes used to classify patients into clinical categories under PDPM.
Proposed Group Therapy definition to change to allow for Group therapy to be delivered to two to six patients doing the same or similar activities.
SNF Value Based Purchasing (SNF VBP) proposed changing the name of the program’s measure to the “Skilled Nursing Facility Potentially Preventable Readmissions after Hospital Discharge” and updates public reporting requirements to ensure that CMS publishes accurate performance information for low-volume SNFs.
SNF Quality Reporting Program (SNF QRP) proposes to adopt two new measures in fiscal year 2020 to assess how health information is shared. This includes 1. Transfer of Health Information from the SNF to another Provider and 2. Transfer of Health Information from the SNF to the Patient.
SNF QRP also proposes to adopt a number of standardized patient assessment data elements; referred to as SPADE which assesses many elements including cognitive function and mental status, special services, treatment and interventions, etc.
Lastly, SNF QRP proposes to change specifications for the Discharge to Community PAC SNF QRP measure to exclude baseline nursing home residents.
INFLUENCING THE 2020 FINAL RULE Concept Rehab leaders and clinical experts will continue to assess this and future updates from CMS and that take proper action to influence and shape the 2020 final rule so that Medicare SNFs and patients are successful. We will continue to alert you with the updated information that you need regarding next years’ rule.