CMS Makes SNF VBP Performance Reports Available

The Centers for Medicare and Medicaid Services (CMS) recently released the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Confidential Performance Score Reports. These reports contain each SNF’s VBP payment adjustment for FY 2019 (i.e., Oct. 1, 2018 – Sept. 30, 2019) along with information on rehospitalization rates and scores used to calculate the payment adjustment.

SNFs with eligible stays during the Calendar Year (CY) 2017 performance period can retrieve their reports through the Certification and Survey Provider Enhanced Reporting (CASPER) System. Those SNFs that had no eligible stays during the performance period will not receive a FY 2019 facility report in the CASPER system and will receive an incentive payment that results in the same federal adjusted per diem rate they would have received absent the SNF VBP program (i.e., no 2 percent withhold).

These confidential performance score reports contain the patient-level stays during the CY 2017 performance period that were used to calculate facility performance. Reports also include facility-level performance and ranking information, which will be posted on Nursing Home Compare. For more information on how to review your Annual Performance Score Report, a tutorial will be made available on the CMSHHS YouTube channel in the near future.

Tab 3 (“Facility Performance”) of the Annual Performance Score Report contains the key information regarding payment adjustment. The Incentive Payment Multiplier shown on the last line of the table on Tab 3 will be applied to a provider’s Medicare rates for the full federal fiscal year. A multiplier of .9800000 indicates that a home is subject to the full 2 percent reduction with no earn-back. A multiplier above 1 indicates that a home’s earn-back exceeds the 2 percent reduction, and the home will receive a net increase.

SNFs can review and submit corrections requests to their performance score and ranking information only during the 30-day Phase Two Review and Corrections Process. The deadline to submit Phase Two Review and Corrections Requests is Aug. 31, 2018. To submit a proper request, SNFs must submit only the following information to the SNFVBPinquiries@cms.hhs.gov mailbox: (1) the SNF’s CMS Certification Number (CCN); (2) the SNF’s Name; and (3) the correction requested and the reason for requesting the correction, along with any evidence supporting the request.

Details on how to access your reports via the Quality Improvement Evaluation System (QIES) and the CASPER reporting application can be found here. Please contact the QIES Technical Support Office (QTSO) Help Desk at help@qtso.com if you need assistance in accessing CASPER/QIES.

Existing law requires that VBP apply to SNF fee-for-service payments starting Oct. 1, 2018 based on an initial performance period of CY 2017. The VBP is being funded with a 2 percent withhold from SNF Part A payments that can be partially earned back based on each facility’s rehospitalization rate and level of improvement.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866