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CMS Proposes Changes to IRF, SNF and Inpatient Prospective Payment Systems

May 01, 2018

Last week the Centers for Medicare & Medicaid Services (CMS) proposed changes to payment systems for IRF, SNF and Inpatient settings. These rules are open for public comment through late-June.

In the SNF setting, CMS proposes an aggregate $850 million increase in Medicare payments to SNFs in 2019. CMS has also proposed a new SNF case-mix model, the Patient Driven Payment Model (PDPM) which seeks to tie payment to patient’s conditions rather than volume of service provided.

CMS is also proposing a 1.35% increase to IRF payments for 2019. The IRF proposed rule details recommendations regarding decrease in documentation burden as well as an emphasis on meaningful quality measures.

Finally, the Inpatient rule proposes a $50 million increase in payments for 2019. During the comment period, CMS is seeking feedback on mechanisms for better achieving sharing of health care data between providers. Your Academy is in the process of reviewing the proposed rules and will submit comments on behalf of the membership this summer.