Review Your Skilled Nursing Facility Value-Based Payment Multiplier By 9/26/19

CMS announced on August 27, 2019 that corrected Skilled Nursing Facility (SNF) Value-Based Payment (VBP) program Performance Score Reports were added in your SNF’s CASPER folder.

The revised reports, which are indicated with “Corrected” in the Excel spreadsheet, correct an error in the baseline data calculations for FY2016. Incorrect reports were removed from the CASPER folders.

Under Phase II of the SNF VBP Review and Corrections process, SNFs can seek correction to only the performance score and rank, but not the underlying patient readmission data. SNFs have 30 days (or until September 26, 2019) to request such correction. Correction requests should be submitted to SNFVBP@rti.org.

You can view your performance score, rank, and multiplier under tab 2 “Facility Performance” (as pictured below).

As a reminder, the SNF VBP commenced on October 1, 2018 using the SNF 30-Day All-Cause Readmission Measure (SNFRM). The SNFRM evaluates the rate of unplanned, all-cause inpatient hospital readmissions of Medicare beneficiaries within 30 days of being discharged from a prior hospital stay. SNFs are scored on improvement (compared to their baseline performance rate) and achievement (compared to the national performance rate during the baseline period). For FY2020 (commencing October 1, 2019), the performance period is 10/1/17 – 9/30/18 and the baseline period is 10/1/15 – 9/30/16.

The Centers for Medicare and Medicaid Services (CMS) withhold 2% of SNFs fee-for-service Part A Medicare payments and then re-distribute 60% of the withhold to SNFs as incentive payments. Therefore, SNFs with performance scores ranked in the lowest 40% nationally will receive a payment rate lower than they would otherwise receive without the SNF VBP program.

Based on the FY2019 (commencing October 1, 2018) SNF VBP data on the Nursing Home Compare website for the 83 RI SNFs:

Highest multiplier: 1.016468
Lowest multiplier: 0.980246
SNFs > 1: 21
SNFs < 1: 60

Contact your Citrin Cooperman health care representative to help you evaluate the impact of your proposed SNF VBP multiplier on your Medicare rates effective October 1, 2019.