The Centers for Medicare & Medicaid Services (CMS) has released its final rule on payments to skilled-nursing facilities (SNFs) for federal fiscal year (FFY) 2024.
Payment rates in the final rule will result in an estimated net increase of 4% (compared with 3.7% as proposed) or approximately $1.4 billion as compared with payments made in FFY 2023. The increase is based on a 3% SNF market basket increase plus a 3.6% market basket forecast error adjustment and less a 0.2% productivity adjustment and an additional negative 2.3% market basket adjustment resulting from the second phase of the Patient Driven Payment Model parity recalibration.
CMS finalizes several proposals for changes to the SNF value-based purchasing program (VBP), which rewards SNFs with incentive payments based on the quality of care they provide. New measures adopted in the VBP program in future years include those that address nursing staff turnover, discharge function, long-stay hospitalizations, and falls with major injury and readmission. CMS also replaces the SNF all cause readmissions measure with a within stay potentially preventable readmissions measure. Additionally, the final rule incorporates an equity adjustment in the SNF VBP program, increases the payback percentage, and updates the validation process for quality measures.
CMS also finalizes several updates to the SNF quality reporting program, including measures addressing discharge function and COVID-19 vaccination status for both patients and health care personnel. The final rule also removes several items that are deemed unnecessary and/or duplicative of other measures, confirms its intent to publicly report the transfer of health information measures beginning with the October 2025 refresh of Care Compare. After considering public comments received, CMS is not adopting the CoreQ: Short Stay Discharge.
CHA staff are reviewing the rule further and will provide a detailed summary shortly. Additional information on the final rule is available in a CMS fact sheet.