CMS cuts payments to 11,000 nursing homes, cites readmission rates

Medicare is modifying one year's worth of payments to 14,959 skilled nursing facilities based on readmission rates, according to a Kaiser Health News report.

Nearly 11,000 nursing homes will face penalties, while nearly 4,000 others will receive bonuses, the report states.

"To some nursing homes, it could mean a significant amount of money," Thomas Martin, director of post-acute care analytics at CarePort Health, told KHN. "A lot are operating on very small margins."

The payments factor in how often nursing home residents are rehospitalized within 30 days of leaving. They aim to reduce preventable hospital admissions of residents and dissuade nursing homes from discharging patients too quickly, according to the report.

Nursing homes will receive the bonuses and penalties during the fiscal year that began Oct. 1 and ends Sept. 30, 2019. The bonus for best-performing nursing homes is 1.6 percent more per Medicare patient, and the worst-performing nursing homes will see a penalty of nearly 2 percent of each payment. 

The incentive payments, which do not apply for patients covered by private Medicare Advantage, are part of CMS' Skilled Nursing Facility Value-Based Purchasing Program. To determine the payments, Medicare factored in performance on the program's hospital readmissions measure during calendar year 2017 and examined improvement made since calendar year 2015.

Scores for individual nursing facilities nationwide are available here.

Access KHN's full report here.


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New rules for drug companies in federal discount program start Jan. 1


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