The Centers for Medicare & Medicaid Services April 4 issued a proposed rule for fiscal year 2024 for the skilled nursing facility prospective payment system, which would increase aggregate Medicare spending by 3.7% or $1.2 billion compared with FY 2023.
This reflects a proposed 2.7% market basket update, a 3.6 percentage-point increase to counter the agency’s market basket error in FY 2022, and a 0.2 percentage-point productivity decrease. It also includes a proposed 2.3-percentage point cut to offset an increase in aggregate FY 2020 Medicare payments under the new SNF PPS, known as the Patient Driven Payment Model.
For the SNF Quality Reporting Program, CMS proposes to adopt three new measures and modify an existing measure on COVID-19 vaccination among health care personnel. CMS would also remove three quality measures and begin publicly reporting of two existing measures.
For the SNF Value-based Purchasing Program, CMS proposes to adopt four new quality measures, including one on nursing staff turnover, and replace one measure with a new, similar measure. The agency also proposes the adoption of a Health Equity Adjustment that rewards SNFs that perform well who have resident populations with at least 20% with dual eligibility status. Correspondingly, CMS would also increase the payback percentage from the current 60% to 66% so that this adjustment does not come at the expense of other SNFs.
CMS will accept public comments on the proposed rule through June 5.