Much attention has been focused on聽a efforts to find ways to聽finance an extension of the current payroll tax break and to prevent in Medicare payments to physicians. But聽the nursing home industry is also facing some stiff funding reductions, and an industry trade group聽has come up with a proposal to help Congress cut Medicare spending while shielding nursing homes.
A proposal from the , which represents skilled nursing facilities, has offered lawmakers a plan the group believes will help cut the readmission rate for nursing home patients to the hospital. That,聽the association says, would save Medicare money.聽Nursing homes would prefer their ideas over another money-saving聽provision in the payroll tax extension/Medicare 鈥渄oc fix鈥 legislation passed last year by the House. That bill would reduce Medicare鈥檚 reimbursement to cover 鈥渂ad debt鈥 incurred by skilled nursing facilities, hospitals and other providers from 70 percent to 55 percent by 2015.
The Senate did not adopt that House plan, but the issue is again before Congress as lawmakers seek to find a way to pay for the Medicare “doc fix” and the payroll tax holiday. A conference committee dealing with the issue has scheduled another session for Wednesday. For skilled nursing facilities in 19 states and the District of Columbia, the cut proposed by the House would be worse that the 2 percent Medicare provider cut called for in , a series of automatic cuts scheduled to begin in 2013, the association says.
The nursing homes鈥 proposal would have the secretary of Health and Human Services establish a baseline for the skilled nursing facilities’ 30-day readmission rate and determine how much those readmissions cost Medicare. Then HHS would set a targeted readmission reduction goal for the skilled nursing homes necessary to achieve $2 billion in savings from 2014 to 2021.
If the target is not achieved, then nursing facilities’ 鈥渕arket basket updates,鈥 or pay increases from Medicare, would be cut to make up for the shortfall. If the skilled nursing facilities meet the $2 billion target, then nursing homes and taxpayers would share in the additional savings.
The industry is still reeling from an that went into effect last Oct. 1. The payment change, which the聽 Centers for Medicare and Medicaid Services said would fix an “unintended spike in payment levels and better align Medicare payments with costs,” is separate from any cuts the industry would face in sequestration. Skilled nursing facilities fought unsuccessfully to have the payment change phased in gradually rather than immediately.
