AHA pushes CMS for improved skilled nursing reimbursement, resources

The American Hospital Association is calling for CMS to update its methodologies regarding reimbursement for skilled nursing facilities because proposed numbers fall far short of rising costs.

In a June 5 AHA letter, Stacey Hughes, executive vice president of government relations and public policy, said that, while such proposed 2024 reimbursement rates are 3.7 percent above the previous year, that is still well below estimated 18 percent cost increases for hospitals between 2020 and now.

"AHA is appreciative of the net positive update, particularly the positive forecast error adjustment," the letter stated. "However, we remain concerned that CMS' market basket approach continues to show lags in recognizing inflationary trends and may not fully capture the rising costs of care."

Recent annual increases have been 2.2 percent in 2021, 2 percent in 2022 and 3.6 percent in 2023, the AHA letter stated. While such data is largely focused on hospitals, the figures are compatible with skilled nursing facilities with their similar "heavy reliance on nurses, therapists and other clinicians, as well as medical supplies."

Improvements to the current CMS methodology would help the 700 skilled nursing facilities the AHA represents receive more efficient and suitable reimbursement, according to the letter.

"The AHA encourages CMS to work with stakeholders to explore updates to the SNF market basket methodology, potentially with new proxies or alternative data," AHA said. "This will ensure CMS can provide the most accurate and timely payment update to SNFs and avoid disruptions in the continuum of care for Medicare beneficiaries."

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