You Are Here:Home/Resources/Billing and Payment Initiatives/Billing and Payment Initiatives Details
Topics covered include:
The enhanced Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) review and correct reports are now available, on demand in the Certification and Survey Provider Enhanced Reporting (CASPER) application. In addition to enhanced sorting functionality, this report now includes patient level data and automated CSV file creation functionality that contains patient level results. Providers can access these reports by selecting the CASPER Reporting link on the “Welcome to the CMS QIES Systems for Providers” webpage.
NOTE: You must log into the CMS Network using your CMSNet user ID and password in order to access the “Welcome to the CMS QIES Systems for Providers” webpage.
In addition to the sorting enhancements and inclusion of resident level data, these reports:
A new Question and Answer (Q+A) document is now available. The Q+A document reflects frequently asked questions that were received by the SNF QRP Help Desk during the fourth quarter (Oct - Dec) of 2018.
· SNF QRP Quarterly FAQ Update Q4 2018 [PDF, 268KB]
October 1 will be here before we know it. And with that comes Medicare’s new Patient-Driven Payment Model (PDPM) for beneficiaries accessing their SNF Part A benefit. It seems like every day there is a new webinar being advertised to help you understand all of the ins and outs of PDPM. It is definitely a more complex system than the RUG-IV system we operate under currently. As we analyze data collected in our facilities, trying to understand where we stand in a PDPM world, there is one other thing to consider: your therapy contract.
Evaluation of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents – Payment Reform (NFI 2) Initiative Year 1 (FY 2017)
CMS is pleased to share the second annual report of the “Evaluation of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents—Payment Reform.”
Early findings in the report are preliminary and should not be considered conclusive. Nevertheless, the evaluation found some promising evidence that payment reforms have led to a consistent pattern of improved outcomes in newly-recruited facilities. Facilities that had participated in an earlier phase of the Initiative did not show further improvements beyond what was expected based on the trends established during that phase.
For both groups, additional years of data and analysis should provide more definitive insight about Initiative effects.
SNF users were notified by CMS on Monday, March 11, that the Review and Correct report in the ‘SNF Quality Reporting Program ‘ category in the CASPER Reporting application would be unavailable while enhancements were being applied to the report. This report is now available and contains the following enhancements:
• The addition of two new measures starting April 1, 2019:
-Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury
-Drug Regimen Review Conducted with Follow-up for Identified Issues – PAC SNF QRP
• The removal of one measure starting with Q4 2018 results:
-Percent of Residents or Patients with Pressure Ulcers That are New or Worsened (Short Stay) (NQF#0678)
• The addition of Resident-Level data will now display with the Facility-Level data results.
-A .csv file output will be available for the Patient-Level data
• The Resident-Level and Facility-Level data will have new filter/sorting functionality within the CASPER Report Submit screen to customize the reporting results.
For several years now, the Centers for Medicare & Medicaid Services (CMS) has been working to transform both payment and care delivery in the Medicare program. A key vehicle in the agency’s efforts is the Accountable Care Organization (ACO).
The new Skilled Nursing Facility (SNF) Provider Threshold Report (PTR) is now available. This PTR is a user-requested, on demand report which enables users to obtain the status of their data submission completeness related to the compliance threshold required for the SNF Quality Reporting Program (QRP).
Currently, Fiscal Year (FY) 2020 and FY2021 are available for user selection for this report to assist providers in reviewing Calendar Year (CY) 2018 and CY2019 data submission. The SNF PTR will display an asterisk (*) for future dates (monthly and quarterly) when a measure is active, but data are not available yet.
This report is available in the ‘SNF Quality Reporting Program’ category in the CASPER Reporting application. Please refer to Section 13-SNF Quality Reporting Program in the CASPER Reporting MDS Provider User’s Guide for additional information about this report.
Skilled Nursing Facility Quality Reporting Program Data Collection & Final Submission Deadlines for the FY 2021 SNF QRP
This table provides the data collection time frames and final submission deadlines for the Fiscal Year (FY) 2021 Skilled Nursing Facility Quality Reporting Program (SNF QRP). The first column displays the measure name, the second column displays the data collection time frame, and the third column displays the final data submission deadlines.
To access this article, please login or sign up for a membership.