Skilled Nursing Facility Value-Based Purchasing Program

The Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP) is an incentive payment program for SNFs paid under the Prospective Payment System (PPS), which focuses on the quality care delivered to Medicare recipients. This program was created in the hopes of reducing hospital readmissions.

The SNF VBP was initiated under the 2014 Protecting Access to Medicare Act. This act mandated that the Centers for Medicare & Medicaid Services (CMS) implement the program, which would link Medicare Part A payments to the SNF’s re-hospitalization rate. Specifically, SNFs will be assessed on a hospital readmission measure, where the patient has a hospital admission 30 days after being discharged. SNFs will receive two performance scores; one based on their individual performance, and one based on their comparison to other SNFs in the nation. Based on their performance, SNFs will receive an annual payment adjustment factor. SNF performance reports will be available on the Nursing Home Compare website.

The SNF VBP began issuing payments at the start of fiscal year (FY) 2019, which was October 1, 2018. Payments are based on the SNF’s performance according to the hospital readmissions measure during the period January 1, 2017, through December 31, 2017. Payments for FY 2020 will based on the performance period of October 1, 2017, to September 30, 2018.

CMS will provide quarterly confidential reports to the SNFs regarding their performance. These reports can be accessed through the Quality Evaluation System (QIES) and the CASPER reporting application. Additionally, CMS will provide the annual confidential feedback report to the SNF. This will contain the performance information that will be made public.

Following is a step-by-step instruction on how to access your facility’s Confidential Quarterly SNF VBP reports:

1. Log in to the CMS network with your CMSNet user ID and password.
2. Select “CASPER Reporting” toward the bottom of the “Welcome to the CMS QIES Systems for Providers” web page.
3. This will bring you to the CASPER login page where you will enter your QIES user ID and password. These credentials are the same as those you use to submit MDS 3.0 records to the Assessment Submission and Processing system.
4. On the CASPER Topics page, select “Folders,” which is a tab on the menu bar toward the top of the page.
5. Select the SNF shared folder, which is the SNF non-VR folder.
6. A list of SNF VBP report links will display.
7. Choose the report you would like to view.

For the full set of instructions from CMS, download: Accessing Your SNF Confidential Quarterly Facility Reports.

In summary, the SNF VBP will focus on quality instead of quantity, placing patient care in the forefront. If you have any questions regarding the above, please contact a member of Marcum’s healthcare group.