Medicare Reimbursement Update – VBP Annual Performance Score Reports Now Available

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In the past year it has become more complicated for skilled nursing facilities (SNF) to understand and calculate their Medicare per diem reimbursement rates. Effective, October 1, 2018, the SNF Value-Based Purchasing (VBP) Program applied either a positive or negative adjustment to a SNF’s per diem Medicare rate based on its performance on the SNF 30-day all-cause readmission measure. The VBP Program applies to all SNFs that are paid under Medicare’s SNF Prospective Payment System. It’s critical that SNFs understand how much they will be paid for the valuable services they provide.

The VBP Program is funded by a 2 percent withhold from provider rates, which resulted in some SNFs seeing up to a 2 percent reduction this past year in Medicare reimbursement. The VBP adjustment is called the incentive payment multiplier, and it’s reported to SNFs via the VBP Annual Performance Score Report, which can be accessed through the Certification and Survey Provider Enhanced Reports (CASPER) system. CMS just announced the VBP annual reports became available to SNFs on August 2, 2019. The annual report should be located in the facility mailbox of the reporting system. SNFs should review this report to obtain their incentive payment multiplier, which will be applied to their Medicare claims from October 1, 2019, through September 30, 2020, and will ultimately affect the total amount of Medicare reimbursement received.

If your facility has not registered with CASPER or if you’re having difficulty obtaining your SNF VBP annual report, contact the help desk at help@qtso.com. SNFs only have 30 days from when the annual report becomes available to submit any potential corrections to their VBP performance scores. In addition, providers should work with their software vendor to determine the appropriate steps for entering the updated incentive payment multiplier into their system effective October 1, 2019, in order to accurately calculate the amount of Medicare receivables and revenues within the financial statements.

For more information on the SNF VBP Annual Performance Score Report, contact your local BKD trusted advisor or complete the Contact Us form below.

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