1. SNF and VBP CMS is in the process of doing two things that will significantly change SNF reimbursement by 2018  CMS must specify a SNF all-cause, all-condition readmission measure  By October 2016, they must then specify an all-condition, risk-adjusted potentially preventable hospital readmission rate Based on the SNF readmission measure, the Secretary must establish a performance standard for SNFs which will rank SNFs annually  The lowest 40 percent of SNFs (by ranking) will be reimbursed less than they otherwise would be reimbursed without the SNF VBP program  In order to fund the incentive payment pool, CMS will withhold 2% of SNF Medicare payments starting October 1, 2018 and redistribute 50-70% of the withheld payments back into the profession by way of incentive payments to SNFs  CMS will retain the remaining 30-50% of funds as programmatic savings to Medicar. The program also requires the Secretary to publicly report the performance on the readmission measure for each SNF on Nursing Home Compare beginning on October 1, 2017. 1

2. As Part of Payment Reform CMS is expanding the scope of the SNF Therapy Payment Research project  Watching “trends” MDS 3.0 changes are coming in October 2016 Special Focus Surveys 2

3. What Can You Do? Track readmissions now and use QAPI Pay attention to your Five Star and be ready for PBJ Track therapy vs medically complex admissions Review your program  Study where you can increase reimbursement (i.e., right scoring of the MDS)  Know where you can decrease cost, (i.e., unnecessary meds or labs) Protect yourself from audits – and losing $ now 3