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Nursing Home Medicare Rates Change on Oct. 1st

October kicks off the federal fiscal year. We remind nursing home members that a listing of regional Medicare Part A rates that go into effect on Oct. 1st is available for download here. The memo we published in August outlining payment provisions included in the 2019 Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) Final Rule is available here.

While the rates incorporate a 2.4 percent market basket increase that varies based on regional wage index changes, they also are subject to the SNF Value Based Payment (VBP) adjustment for the first time. The adjustment is based on a home's performance on the SNF VBP hospital readmission measure and uses a facility-specific "incentive payment multiplier" to decrease rates for most homes by as much as 2 percent. Homes with top scores on the measure may see a positive adjustment up to roughly 2 percent. The Centers for Medicare and Medicaid Services (CMS) notified homes of their incentive payment multiplier through the VBP Annual Performance Score Reports. Information on accessing the reports is available here.

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