Q: How should we manage SNF value-based purchasing measures to receive incentive payments?
A: Currently, the SNF VBP program only uses the SNF 30-day all-cause readmission measure. The measure includes Medicare Part A beneficiaries who are admitted to directly from the hospital and have an unplanned readmission to the hospital within 30 days of the prior hospital discharge.
What is sometimes overlooked are the residents who discharge after a short stay, back to the community for example, and are subsequently readmitted to the hospital from home. If the readmission occurs with 30 days, it is included in the calculation. This means you need to monitor hospitalizations during the SNF stay and also focus on safe discharge planning and post-discharge follow-up practices.
The Centers for Medicare & Medicaid Services provides confidential feedback reports to your SNF through the CASPER reporting system, and there is a review and correction process that allows for correction requests to be accepted.
Two percent of each SNF’s Medicare Part A payment is withheld to fund the VBP program. Some 60% of that amount is then redistributed to SNFs in incentive payments. The measure will be reinstated after a COVID-era suppression, and the following measures are soon being added to make the SNF VBP more robust (with proposals at top left coming later):
- Healthcare-Acquired Infections Requiring Hospitalization (FY 2026)
- Total Nursing Hours per Resident Day (FY 2026)
- Baseline period FY 2022; performance period FY 2024
- Discharge to Community (FY 2027)
- Baseline period FY 2021-2022; performance period FY 2024-2025
Please send your payment-related questions to Eleisha Wilkes at [email protected].
