Avalere's Bentley: SNF Care Fundamentally Changing Because of Payment Changes

Payment for home health care is also getting a makeover starting next yaer
Peter Wehrwein

Post-acute care suffers from lack of coordination and communication, Fred Bentley, a managing director at Avalere wrote this week. 

But in a piece titled, "4 Things Hospital Executives Need to Know about Post-Acute Care," Bentley says that a new CMS payment system for skilled nursing facilities "will fundamentally alter how your patients are treated in the post-acute setting."

The implementation of the payment system, which began in October, alters payment for SNFs from a system that was based on the volume of therapy to one that hews more closely to a person's clinical condition and needs, according to Bentley.

"These changes are expected to better align reimbursement with patients' clinical needs and increase reimbursement for more medically complex patients," he wrote in a piece posted on the Avalere website.

The Patient-Driven Payment Model, as CMS calls it, is also encouraging nursing homes to experiment with less intensive care. 

The model has had a long gestation period. The rules for it were finalized in July 2018.

Bentley says CMS is expected to reformat payment for home health providers in a similar fashion in rules that are scheduled to come out in January.