The report shows SNFs if they are meeting the 80% reporting threshold requirement on the SNF QRP measures during a calendar year.  Failure to meet this threshold can result in a SNF having its Medicare Fee-For-Service rate reduced 2% in the forthcoming fiscal year.  For this reason, SNFs should review the PTR now to see if they are below the 80% threshold on any of the measures, as they have until May 15, 2019 to make updates or corrections to their current MDS submissions for, at least, 10/1/2018 – 12/31/2018.   

Recent research found that hospitals with health information exchange (HIE) have fewer readmissions than do hospitals that are not part of HIE. This study looked at data from 160 Florida hospitals and focused on patients who had been hospitalized for a heart attack.

The good news is that 3,983 SNFs received an increase in their rates over and above earning back the 2% that CMS takes to fund the incentive pool.  Of those, 440 SNFs (2.9%) were assigned a number 1 rank and as such received the maximum rate increase of roughly 1.65% increase on their Medicare FFS rates (after the 2% was restored).  And another 347 SNFs benefitted from the hold harmless provision CMS established in the regulations for low-volume SNFs by applying the 1.00 modifier.

LeadingAge CAST has updated its Telehealth and RPM Selection Tool with new vendor information and a new case study from Curatess and Lexington Health Network. The product matrix and online selection tool now contain information for 16 products from 13 vendors. The tool is designed to help aging services organizations understand telehealth and remote patient monitoring (RPM) technologies, as well as these technologies’ uses and benefits.


CMS staff shared that less than 2% of the 15,191 Skilled Nursing Facilities(SNFs) received a noncompliance letter and of those that did, roughly 50% submitted a request for reconsideration and supporting documentation. CMS granted reconsideration for about half of those SNFs who requested it stating they had made a compelling argument demonstrating that they had been using the CASPER system reports but fell short in meeting the 80% threshold reporting requirement. Those SNFs who were granted reconsideration will not be penalized the 2% off their Medicare Fee-For-Service(FFS) rates.

We based our comments to CMS on our analysis of common compliance issues we found among LeadingAge member nursing homes who received QRP noncompliance notification letters and resulting 2% reductions in their Medicare rates.

We noted in particular the suggestion we received from many of our members that monthly or quarterly reports on their reporting percentages would enable them to identify problems and take corrective action at an earlier stage of the reporting process. We also recommended that CMS explore more efficient mechanisms for necessary documentation to be transmitted.

Payment Update

The hospice payment update percentage for FY 2019 is based on the inpatient hospital market basket update of 2.9% with the multifactor productivity (MFP) adjustment of -0.8% to yield a final update of 1.8% for hospice providers who submit the required quality data. Those hospice providers that did not submit the required data will receive a -0.2% payment update.


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