In a report produced jointly by the Medicare Payment Advisory Commission and the Urban Institute, MedPAC is urging CMS to adopt an alternative design for payment accuracy within Medicare’s system.
Between 2006 and 2014, payment accuracy has steadily decreased. The deficiencies in Medicare’s payment system for skilled nursing facilities have driven CMS to make many revisions to it, including shifting payments from therapy care towards nursing care. Therapy payments are often overpaid, however, and as a result, SNFs have incentives to shift their patient mix toward therapy groups.
The findings conclude that CMS’s changes have not improved payment accuracy and more fundamental reforms are required.