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CMS Issues SNF VBP Fact Sheet

The Centers for Medicare and Medicaid Services (CMS) issued a special edition Medicare Learning Network (MLN) article reminding nursing homes that implementation of the Value Based Purchasing (VBP) program will impact their Medicare Part A rate beginning in October 2018. Rates will be reduced by 2 percent for all homes, and 60 percent of the money withheld will be used to provide incentive payments to homes that perform well on the all cause, 30-day hospitalization measure. Homes will receive a score based on this measure that will take into account both achievement and improvement, then will be ranked from highest to lowest score. Higher scorers will receive higher incentive payments, while the lowest scorers are likely to receive none.

October 2018 VBP incentive payments will be based on a performance period covering Calendar Year (CY) 2017. Improvement will be measured from a CY 2015 baseline. Note that incentive payments effective October 2019 will be based on the performance period from October 2018 through Sep. 30, 2019 and be compared to baseline performance between Oct. 1, 2015 and Sept. 30, 2016.

The CY 2015 readmission rates are available here. The 2015 national average readmission rate was 19.002, while the New York State average was 19.248. State averages ranged from a low of 17.626 in Washington to a high of 20.288 in Arkansas. Within the state, county average rates ranged from 15.621 to 21.364, with Schuyler, Saratoga, and Madison counties reporting the lowest rates and Columbia, Chemung, and Putnam reporting the highest. CMS intends to complete calculating 2017 readmission rates and share the resulting scores with each nursing home in August 2018, in preparation for public dissemination and October Medicare Part A rate adjustments.

The fact sheet is available here, the CMS SNF VBP page is here, and instructions for accessing VBP Confidential Quarterly Facility Reports are available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841