Nursing homes push back against CMS value-based purchasing proposals, but welcome stability amidst ongoing changes.
The Centers for Medicare & Medicaid Services (CMS) has proposed a rule that would stabilize the process of selecting, retaining, and removing measures in the Value-Based Purchasing (VBP) program for skilled nursing facilities (SNFs). The proposed rule includes eight specific factors that CMS would consider when determining whether a measure should be removed or replaced. These factors include uniformly good performance across a measure, signaling that “meaningful distinctions and improvements in performance can no longer be made”; and whether improvement on a given measure is helping resident outcomes.
The proposed rule also states that once a measure is adopted for the VBP program, it would automatically be retained for all subsequent years unless CMS specifically proposes to remove or replace it. This policy would mean that CMS would not have to continuously propose a measure for inclusion year after year.
Industry experts welcome this proposal as it brings stability to the process and allows SNFs to focus on improving quality without worrying about changes in measures every year. However, there may be some critics of specific measures, but overall, the proposal is seen as a positive step forward.
The proposed rule also mentions that CMS is considering adding new measures related to interoperability, health equity, and social determinants of health. Additionally, CMS is assessing several resident experience measures and considering whether a composite staffing measure is feasible, which would combine the two separate staffing measures in the current set.
Public comments on the proposed rule are being gathered through May 28.