The prospect of site-neutral reimbursement rates is one step closer, holding out the possibility that SNFs will no longer be paid less than inpatient rehab facilities for providing similar care.
Under a plan approved by the Medicare Payment Advisory Commission (MedPAC), which will likely be submitted to Congress in June, rates for SNFs, home health providers, inpatient rehab facilities and long-term care hospitals would be standardized according to patient conditions, as opposed to the current model, where rates vary according to the care setting.
While Congress may or may not act on MedPAC’s recommendation, McKnight’s reports that “long-term care lobbyists have generally lauded [the concept],” with editorial director John O’Connor writing, “It’s no surprise that skilled operators would like to snap off a piece of that inpatient rehab payment action.”
But O’Connor and others in the industry also note that caution is warranted, given how many details must still be determined. Cheryl Phillips, M.D., senior vice president of LeadingAge, has stated that the model “sounds theoretically good,” but notes that patients’ individual needs must be taken into account.
O’Connor also warns SNFs to remember the Medicare payment adjustments of the 1990s. “That shift was initially hailed by several industry leaders as a way for operators to finally get paid for tendered services,” he writes. “Half a decade later, more than 1,000 skilled care operators were seeking creditor protection. Oops.”
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