Comment Deadline Approaching on SNF Readmission Measure, Quality Reporting Measures
As previously reported, the Centers for Medicare and Medicaid Services (CMS) published the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Proposed Rule for FY 2017 in April. The proposed regulation would update SNF Part A Medicare rates and revise the SNF Value-Based Purchasing (VBP) Program and Quality Reporting Program (QRP). CMS will accept comments on the proposed rule until June 20th.
LeadingAge has prepared a summary of the rule which also encourages member SNFs to submit their own comments on certain aspects of the regulation. We are also inviting members to review LeadingAge New York’s draft comments on the regulation, which are also under review by our Nursing Facility Cabinet. If you have any input on our draft comments, please contact Dan Heim by e-mail (dheim@leadingageny.org) or phone (518-867-8383, ext. 128) by this Thurs., June 16th.
In the rule, CMS proposes to revise the hospitalization measure to be used in the VBP program from a 30-day all-cause readmission measure to a more refined 30-day potentially preventable readmission measure. The scoring methodology would consider performance and improvement on this measure, with 2015 Calendar Year (CY) claims used as the baseline measure and CY 2017 claims as the performance period for SNF VBP in 2019.
To meet statutory requirements, CMS previously proposed quality measures to include in the SNF QRP. In this regulation, CMS proposes four additional measures (the top three to be used in FFY 2018 QRP, the final one, Drug Regimen Review, to be used in 2020): (1) Discharge to Community: assesses successful discharge to the community from a SNF setting; (2) Medicare Spending per Beneficiary: calculates total Medicare Part A and Part B payments within an “episode of care”, which includes the period during which a patient is in a SNF and during a defined period after the end of the SNF treatment; (3) Potentially Preventable Readmission: assesses the facility-level risk-standardized rate of unplanned, potentially preventable hospital readmissions for Medicare FFS beneficiaries in the 30 days post-SNF discharge; and (4) Drug Regimen Review: measures whether SNFs and other providers were responsive to potential or actual clinically significant medication issue(s) when such issues were identified. Beginning in payment year 2018, SNFs that fail to submit data required by the QRP will face a two percentage point reduction in their annual rate update.
The text of the proposed rule is available here. CMS background information on SNF VBP is posted here. QRP background is here.
Contact: Dan Heim, dheim@leadingageny.org, 518-867-8383, ext. 128