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Ayn Llopis
Accountant | Tax Strategist | Virtual CFO | Founder-ACTvisory | Passionate about helping leaders find clarity in their KPIs
CMS’s Final Payment Rule
“The Squeaky Wheel” got the attention of decision makers. CMS went beyond what was expected in a positive way with the SNF final rule allowing for PDPM reduction in reimbursement to be spread out over two years and a 2.7% pay bump for 2023. CMS received more than 4,700 comments during the 60-day feedback period on both the proposed cuts AND the implementation of a federal staffing standard.
Nursing operators are still working with CMS to better align Medicare reimbursement with what’s going on in the rest of the country. CMS must recognize that the right reimbursement mirrors the current facility expenses. At the state level there have been a lot of programs that increased Medicaid funding across the board which helps many rural skilled nursing providers.
The breakdown of what the rule means is:
·????????2.3% cut or $780 million reduction in 2023
·????????Another 2.3% reduction in 2024
·????????2.7% bump to their payments in 2023
Where originally CMS planned to adjust SNF payment rates by 4.6% or $1.7 billion over the course of one year.
This is a step in the right direction of factoring in cost against reimbursement. Operators must continue to do a better job of telling CMS how expenses, inflation and staffing has impacted the care model. Medicaid increases have been going up, but Medicare has not.