News, Payment/economy, Regulations, Skilled Nursing Facility

2014 SNF Proposed Rule Analysis: Payment changes breakdown

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule that would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for 2014.

CMS estimates that aggregate payments to SNFs will increase by $500 million, or 1.4 percent, from payments in 2013.

This is based on:

  • 2.37% Update factor
  • -0.50% Market basket forecast error or adjustment
  • -0.40% Multifactor productivity (MFP) adjustment per ACA 2010

Note:  If more up-to-date data becomes available for the final rule, CMS will apply it.

The budget neutrality factor remains unchanged at 1.003

For the wage index adjustment, there are some minor CBSA (Core-based Statistical Areas) changes that include a few new CBSAs, shift of some urban areas to rural, shift of some rural areas to urban, and some CBSAs will be split.

Also, effective 10/1/2013, Tables A and B will no longer be attached to the actual final rule.  Instead, to be consistent with other Medicare payment systems, they will be published on the CMS Medicare website.

  • TABLE A: FY 2014 INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS
  • TABLE B: FY 2014 WAGE INDEX BASED ON CBSA LABOR MARKET AREAS FOR RURAL AREAS

Read the proposed rule here. Comments must be received by 5 p.m. on July 1, 2013.