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Robert B. Vogel, MD, JD
Retinal Ophthalmologist at Piedmont Eye Center, Lynchburg VA;
Attorney, Overbey Hawkins & Wright, PLLS, Lynchburg, VA;
Adjunct Professor, Humanities and Bioethics, Liberty University School of Medicine, Lynchburg, VA.
The Centers for Medicare and Medicaid Services (CMS) has issued its proposed rule for fiscal year (FY) 2019 Medicare payments and policy changes for skilled nursing facilities (SNFs), hospices, and inpatient psychiatric facilities.
CMS has proposed a new case-mix classification system for SNFs, now called the Patient-Driven Payment Model (PDPM). The new system “is designed to improve the incentives to treat the whole patient, instead of focusing on the volume of services the patient receives, which requires substantial paperwork to track over time.”
There also are proposed changes to the SNF Value-Based Purchasing Program (VBP). The VBP proposal is to “apply either positive and negative incentive payments [to SNFs] based on their performance on the program’s readmissions measure. The single claims-based all-cause 30-day hospital readmissions measure aims to improve individual outcomes through rewarding providers that take steps to limit the readmission of their patients to a hospital.”
SNFs will see an $850 million, or 2.4%, increase in payments in FY 2019. For hospices, CMS is proposing a $340 million, or 1.8%, increase. CMS estimates that inpatient psychiatric facilities (IPFs) will receive a $50 million, or 0.98% increase, in Medicare payments in FY 2019.
More information regarding CMS’s FY 2019 proposals can be accessed on the CMS website.
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