The Centers for Medicare and Medicaid Services (CMS) has released a
host of final payment rules, increasing payments to hospitals, skilled
nursing facilities (SNFs), and other providers in 2019. The rules also
contain a number of provisions designed to ease administrative burdens
and lower providers’ cost of complying with regulations.
To assist healthcare distributors, HIDA Government Affairs has
prepared several resources that outline the changes contained in CMS’s
new payment rules. Here are some key insights from these resources.
Acute and long-term care hospitals
CMS announced it will increase payment rates for acute care hospitals by
1.85 percent and those of long-term acute care facilities by 1.35
percent. As part of the new payment rules, CMS will remove and
de-duplicate a number of measures across the four quality and
value-based purchasing programs.
The rules also contain a number of key changes and requirements for
these providers. For example, acute care hospitals will now be required
to list their standard prices online. The rule also changes the
electronic health record program for these hospitals so that it has a
smaller set of objectives. This move aims to give providers a more
flexible, less-burdensome structure.
Skilled nursing facilities
CMS will increase payments for SNFs by 2.4 percent, according to its new
payment rules. The agency will also implement the new Patient-Driven
Payment Model, which focuses on the patient’s condition and care needs
to determine reimbursement levels.
Other key changes in the SNF payment rule include updates to the SNF
Value-based Purchasing program. These updates change the scoring
methodology for low-volume SNFs, and also includes an exemption policy
for extraordinary circumstances.
Inpatient rehabilitation facilities and hospices
CMS will increase payments to inpatient rehabilitation facilities (IRFs)
by 1.35 percent and payments to hospices by 1.8 percent. The agency
also announced that it will remove certain documentation requirements
for IRFs and will reduce the number of quality measures each must
report. These steps aim to achieve goals set out in the agency’s
Meaningful Measures initiative, which seeks to improve patient outcomes
while reducing the administrative burden on providers.
A common theme across these payment rules, in addition to the slight
payment increase, is the agency’s efforts to reduce the reporting and
administrative requirements on providers in different healthcare market
segments. “We’re excited to make these changes to ensure care will focus
on the patient, not on needless paperwork,” CMS Administrator Seema
Verma comments on the agency’s website. “We’ve listened to patients and
their doctors who urged us to remove the obstacles getting in the way of
quality care and positive health outcomes.”
The agency continues to gather feedback on its regulations, so it is
possible CMS will take further action to reduce the impact of existing
requirements. If you have any questions, or would like to access HIDA’s
resources on CMS’s payment rules,
please contact us at HIDAGovAffairs@HIDA.org.