The CMS is considering smaller payment raises to skilled-nursing facilities, inpatient rehabilitation facilities and hospice care in the year of 2018 compared to this year.
The agency on the day of Thursday proposed skilled nursing facilities get a $390 million increase as payment raises in federal payments for the year of 2018, representing an almost 1 percent increase. This is much less than the $800 million payment hike proposed for skilled nursing facilities previous year.
Medicare would pay $80 million a year more as payment raises to rehabilitation facilities, but that is $45 million less than what the CMS proposed previous year.
Hospices would see payments almost cut in half year over year. Hospices would get an extra $180 million, or 1%, more in payment raises for the year of 2018. In 2017, hospices got a $330 million increase, or 1.1 % raise.
Jonathan Keyserling at the National Hospice and Palliative Care Organization claimed in a statement that the marginal payment hike “further burdens the community facing ever-increasing costs, and compels hospice providers to do more with less.” He added that the payment increase should be twice as much to about 2.2 percent.
The agency also proposed new quality measurements within the rules.
Public comment on the proposed changes can be submitted until the day of June 26.
The CMS claimed in the proposed ruling that the Hospice Compare website will launch sometime in the summer of 2017. The site is proposed to make public quality measurement data.
The CMS will permit stakeholders to make suggestions on how the site’s rating system would work and how the ratings are calculated. Hospices will also be given a thirty-day period to preview reports before they are made available publicly.
Sufferers can also be on hospice for longer than 6 months as long as the individual has a prognosis of six months or less, the CMS proposed. “We’ve recognized in previous rulings that prognostication is not an exact science,” the agency stated.
The number of Medicare beneficiaries getting hospice services has grown from 513,000 in the year of 2000 to almost 1.4 million in FY 2016. Medicare hospice expenditures have also grown from $2.8 billion in 2000 to almost $16.5 billion in the year of 2016.
The CMS projects that hospice expenditures are anticipated to continue to increase by about 7 percent yearly.
The value-based payment program for skilled nursing facilities is set to start in the year of 2019.
The CMS is inquiring stakeholders to consider whether the program should tie reimbursement to social risk factors involving social support, income and employment.
“One of our primary objectives is to make better the beneficiary outcomes involving reducing health disparities, and we need to ensure that all beneficiaries, involving those with social risk factors, receive high quality care,” the CMS said.
In a statement, the American Health Care Association said it acknowledged the CMS’ solicitation of input.
Between the time period of 2001 and 2013, Medicare post-acute care spending grew at an annual rate of 6.1 percent and doubled to $59.4 billion, while payments to inpatient hospitals grew at an annual rate of 1.7 percent over this same period, in accordance to the CMS.
There are more than 16,000 skilled-nursing facilities throughout the country and they admit more than 2 million patients in the traditional Medicare program each year.
The CMS proposed eliminating some claims data requirements on inpatient rehabilitation facilities (IRFs).
A 25 percent payment penalty for IRFs that fail to submit a Medicare Part A claims form has been eradicated. The CMS said the penalty is “no longer required to encourage providers to submit data to the CMS” because submissions are no longer accepted if they lack another form.
The CMS also proposes eliminating a data metric on whether sufferers can swallow on their own without supervision. The agency said it duplicated a provision passed previous year that involved swallowing and nutritional status.
Similar to hospice care, the CMS is inquiring for stakeholder impute if social risk factors should be involved in the IRF Quality Reporting Program.
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