August 28, 2019

SNF Value-Based Purchasing Miscalculation

SNF Value-Based Purchasing Miscalculation

On August 22, 2019, CMS announced that there was a miscalculation in the performance rates affecting the VBP incentive payments that are set to go into effect on October 1, 2019. On the evening of August 26, CMS distributed the corrected reports. These reports are available in a SNF’s Casper folder. Based upon our review of the report, 86% of facilities will see no change to the originally published rates and the remaining providers will only see a fraction of a percentage point variance from their original, incorrect Incentive Payment Multiplier. SNFs have 30 days to review and submit corrections to their VBP performance score and program rank. Due to the revisions made, this correction period is being reset from August 27 through September 26. The corrected incentive payments will be in place as scheduled on 10/1.

Beginning October 1, 2018, all SNFs received an incentive payment adjustment to their Medicare Part A claims. All facilities received a 2% cut in their rate, but were able to earn some, all, or even more of the 2% cut back based on the re-hospitalization rates from prior years. This payment adjustment is recalculated annually. In the first year beginning October 1, 2018, 26% of SNFs earned a positive incentive payment, where they earned the 2% back, plus an additional add-on to their Part A rate. 2% of SNFs, earned their 2% back, and 72% had a negative incentive adjustment where they earned less than the 2% back. It is important that facilities continue to monitor where they are trending and put plans in place to improve their scores, by reviewing their quarterly feedback reports available in the QIES System.

Please contact your Marcum Healthcare professional with any questions.

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