CMS Final Rule Approved: Learn How to Quickly Make an Impact On VBP Measures

On July 31, 2023, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the fiscal year (FY) 2024 Skilled Nursing Facility Prospective Payment System (SNF PPS). The final rule also includes updates to the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) program.

Fischer Health Care Consulting can help you positively impact your SNF VBP measures and increase your revenue.

Changes to the Skilled Nursing Facility Value-Based Purchasing Program

The SNF VBP program rewards SNFs with incentive payments based on the quality of care they provide rather than just the services they provide. CMS is adopting four new quality measures, replacing one and finalizing several policy changes.

Eight new value-based purchasing measures are coming between now and 2028, some of which were approved in the FY 2023 SNF PPS final rule, and some of which were approved in the FY 2024 SNF PPS final rule. Notably, CMS is replacing the SNF 30-Day All-Cause Readmission Measure (SNFRM) with the Skilled Nursing Facility Within Stay Potentially Preventable Readmissions measure (SNF WS PPR) beginning in FY 2028.

Here is a summary of the value-based purchasing measures and when they begin:

1. Healthcare-Associated Infections Requiring Hospitalization (SNF HAI) Measure – Begins FY 2026

2. Nurse Staffing Turnover Measure – Begins FY 2026

3. Total Nursing Hours per Resident Day (Total Nurse Staffing) Measure – Begins FY 2027

4. Discharge to community (DTC) – Begins FY 2027

5. Long Stay Hospitalization Measure per 1,000 Resident Days – Begins FY 2027

6. Discharge Function Score Measure – Begins FY 2027

7. Percent of Residents Experiencing One or More Falls With Major Injury (Long Stay) – Begins FY 2027

8. Skilled Nursing Facility Within Stay Potentially Preventable Readmissions measure (SNF WS PPR) (replaces the SNF 30-Day All-Cause Readmission Measure (SNFRM)) – Begins FY 2028

SNF VPB Program Funding

CMS withholds 2% of SNF’s Medicare fee-for-service Part A payments to fund the SNF VBP program, known as the “withhold.” Improving your measures will help you earn back some of your 2% withhold in the form of incentive payments.

How to Quickly Make an Impact On VBP Measures

Fischer Health Care Consulting can help you improve your skilled nursing facility value-based purchasing program measures. How?

• Our technology maps and tracks all infections in your building in real-time and makes associated infection maps.

• We can track readmissions by specific payor, preferred network affiliation, ACO, physician, condition/specialty, managed care, Medicare, long-stay, short-stay, etc.

• We can track patient disposition/discharge to community.

• We can help your SNF bring specialty care onsite to help lower readmission rates for short-stay and long-stay.

Fischer HCC has the solutions to make a positive impact on your VBP measures. We can do what your EMR can’t. Contact us today to learn how you can put new programs in place, improve your measures and earn back some of your withhold.