Measure
The SNF VBP Program’s Hospital Readmission Measure
The SNF VBP Program awards incentive payments to SNFs based on their performance on the SNF 30-Day All-Cause Readmission Measure (SNFRM; NQF #2510). The SNFRM measures the rate of all-cause, unplanned hospital readmissions for SNF residents within 30 days of discharge from a prior hospital stay. The SNFRM is risk adjusted for stay-level factors including clinical and demographic characteristics. Each SNF receives a SNFRM result (i.e. risk-standardized readmission rate) for a baseline period and a performance period. The following table provides the baseline and performance periods for Fiscal Year (FY) 2020 through FY 2024, as finalized through the federal rulemaking process.
|
Program Year |
Baseline Period |
Performance Period |
|
FY 2020 |
FY 2016 (10/1/2015-9/30/2016) |
FY 2018 (10/1/2017-9/30/2018) |
|
FY 2021 |
FY 2017 (10/1/2016-9/30/2017) |
FY 2019 (10/1/2018-9/30/2019) |
|
FY 2022 |
FY 2018 (10/1/2017-9/30/2018) |
4/1/2019-12/1/2019* |
| FY 2023 | FY 2019 (10/1/2018-9/30/2019) | FY 2021 (10/1/2020-9/30/2021) |
| FY 2024 | FY 2019 (10/1/2018-9/30/2019) | FY 2022 (10/1/2021-9/30/2022) |
FY = Fiscal Year
*In response to the COVID-19 public health emergency (PHE), CMS is excluding qualifying claims in the first two quarters of Calendar Year (CY) 2020 (January 1, 2020 – June 30, 2020) from use in the SNF VBP Program. Additionally, because the SNFRM assesses hospital readmissions within 30 days of discharge from a prior hospitalization to a SNF and requires data from 12 months prior to the start of the SNF stay for risk adjustment, residents that were discharged from the hospital to the SNF after December 1, 2019 and residents with SNF admissions from July 1, 2020 – September 30, 2020 are excluded from the SNFRM calculations due to missing data. Thus, the FY 2022 SNF VBP performance period originally specified in the interim final rule with comment has been restricted to April 1, 2019 through December 1, 2019. For further information please see pages 54835 through 54837 of the interim final rule with comment and the FY 2022 SNF PPS final rule.
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