CMS Posts SNF VBP Rankings

The Centers for Medicare and Medicaid Services (CMS) has recalculated Skilled Nursing Facility (SNF) Value-Based Payment (VBP) rankings and posted a link to the rankings and incentive payment multipliers for all homes on the SNF VBP web page. The multipliers have not changed—they remain the same as what CMS initially distributed, so the update has no bearing on reimbursement. The only thing that has changed is the nationwide ranking for some homes. In the file, homes are identified by their Medicare number.

Members will recall that the SNF VBP program calculates an all-cause hospital readmission rate for each home using Medicare fee-for-service data and assigns a score based on performance and improvement. All nursing homes in the nation are arrayed from highest to lowest score and assigned a payment multiplier that is applied to their Medicare Part A rate. The program is calibrated to provide a savings; therefore, more homes experience a decrease in rate than receive an increase. Highest scoring homes receive a 1.65 percent increase, while homes with the lowest score see a rate decrease of almost 2 percent.

CMS intends to post a more detailed file containing facility-level performance data later this year on Nursing Home Compare. In the meantime, we have posted a file showing the average incentive payment multiplier in each county to allow homes to better gauge how their performance compares with their geographic peers (available here).

Please note that while there are 15,306 homes nationwide that were assigned rankings, due to numerous cases where homes have identical scores, there are only 5,230 unique rankings. For example, 440 homes nationally are tied for the highest score and therefore are all ranked #1. The lowest ranking of #12,159 is shared by 3,148 homes.

Nationwide, 3,984 of the 15,306 homes (26 percent) have a multiplier of 1.00 or higher, meaning that their Medicare Part A rates are unchanged or increased due to SNF VBP. In New York State, 34 percent of all homes, and 41 percent of non-profit homes, earned multipliers that increased their FFY 2019 Medicare rates or left them unchanged.

CMS posts VBP review reports on the CASPER system and offers homes a two-phase review and correction process. Phase one correction requests for 2017 data are due no later than March 31, 2019. Homes must submit correction requests by email to the SNFVBPinquiries@cms.hhs.gov mailbox and include their name, certification number, the correction being requested, the reason for the request, and any available documentation supporting the request. CMS has posted a tutorial explaining the Annual Performance Report here. For questions about accessing CASPER, please contact the QIES Technical Support Office (QTSO) Help Desk at help@qtso.com.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841