The Centers for Medicare & Medicaid Services’ proposed patient-driven payment model for skilled nursing facilities would increase overall payment accuracy, especially for the medically complex patients treated by hospital-based providers, but needs refinement, AHA told the agency in comments submitted today. “The AHA appreciates the extensive work CMS has done to develop an alternative to the current SNF case-mix system,” AHA wrote. “As noted in the rule, the current system has been widely criticized by policymakers for overly concentrating payments on cases with high-therapy utilization…However, our evaluation of the PDPM found that the model still has several flaws, which must be addressed before the PDPM proposal can be finalized.” In its FY 2019 proposed rule for the SNF prospective payment system, CMS proposes the model as an alternative to the current SNF case-mix system beginning in FY 2020.

Related News Articles

Headline
The Medicare Payment Advisory Commission this week recommended that Congress provide a 2 percent market-basket update for the hospital inpatient an
Headline
The Center for Medicare and Medicaid Innovation today announced a new
Headline
Patients in the most rural counties had an 87 percent greater chance of receiving an opioid prescription from their primary care provider between January 2014…
Headline
Commenting today on the Medicare Payment Advisory Commission’s draft recommendations for 2020, AHA said it supports the recommendation to provide current law…
Headline
The U.S. Supreme Court yesterday heard oral arguments in an appeal of a D.C. Circuit Court decision that the Department of Health and Human Services violated…
Headline
The Centers for Medicare…