Harmony Healthcare Blog

Value-Based Purchasing Program (VBP): Skilled Nursing Facility

Posted by Kris Mastrangelo on Thu, May 31, 2018


Edited by Kris Mastrangelo

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Performance Improvement on the Mechanism of Metal Gears.The SNF VBP (Value-Based Purchasing Program), begins Oct 1, 2018 and rewards Skilled Nursing Facilities with motivational payments for performance on reducing hospital re-admissions known as the Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM). 

The calculation is based on a facility’s re-hospitalization rate in Calendar Year 2017 or improvement from Calendar Year 2015 to Calendar Year 2017.  The facility’s Medicare Payment rates may be impacted up to 2% for the entire year starting on Oct 1, 2018. 

Performance Period and Baseline Period 

The below table depicts the Performance Period and Baseline Period for Fiscal Year 2019 and Fiscal Year 2020. As you can see, the periods shift from calendar year to fiscal year time frames for FY 2020. 

Period

FY 2019
Program Year

FY 2020
Program Year

Performance Period

Calendar Year 2017
(Jan. 1, 2017-Dec. 31, 2017)

Fiscal Year 2018
(Oct. 1, 2017-Sept. 30, 2018)

Baseline Period

Calendar Year 2015
(Jan. 1, 2015-Dec. 31, 2015)

Fiscal Year 2016
(Oct. 1, 2015-Sept. 30, 2016)

 

The intent of the Value-Based VBP Program is to reward quality and improve health care.  The calculations involve: 

  • The adjusted Federal per diem rate applicable to each SNF in an FY will be reduced by 2 percent to fund incentive payments for that FY. 
  • The total amount of incentive payments distributed to SNFs will be 60 percent of the total amount withheld from SNFs Medicare payments for that FY.

    Facilities with SNF VBP performance scores ranked in the lowest 40 percent nationally will receive a lower payment rate.  

Public Reporting (Baseline Data Now Available for Public) 

The SNF’s performance data rates from the baseline year (calendar year 2015) affecting Fiscal Year 2019 (I.e., October 1st, 2018) payment determinations is publicly available on Nursing Home Compare. 

The status of each facility’s hospital re-admission score and rank includes the following information: 

  • Rank
  • Provider ID
  • Facility Name
  • Address
  • Baseline Period (CY 2015) and Performance Period (CY 2017) Risk Standardized Readmission Rate (RSRR)
  • National Average Baseline Period (CY 2015) and Performance Period (CY 2017) RSRR
  • Achievement Score
  • Improvement Score
  • Performance Score
  • The Range of Performance Scores
  • The Number of SNF’s Receiving Value-Based Payments
  • The Range and Total Amount of Value-Based Payments 

Download the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program  - Individual Performance

You need the facility Provider Number (CCN) to see the Baseline Period: CY 2015 Risk-Standardized Readmission Rate (%).

Harmony Healthcare International (HHI) is here to help. We understand how much work is involved for you and your staff to run an efficient, compliant, and fiscally sound facility.  

Harmony Healthcare International (HHI) can: 

  • Identify areas of risk and opportunity
  • Education on rules and regulations
  • Implement Systems (QAPI)
  • Monitor progress and performance

Harmony Healthcare International (HHI) performs monthly compliance audits. If you need help with this area, please contact us by clicking here.  Looking to train your staff?  Join us in person at one of our our upcoming Competency/Certification Courses.  Click here to see the dates and locations. 


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7th Annual LTPAC Symposium
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