CMS proposes pay bump for rehab, psych facilities

Inpatient rehabilitation facilities and inpatient psychiatric facilities will likely see Medicare rate increases in fiscal 2023.

The Centers for Medicare and Medicaid Services proposed inpatient rehabilitation facilities get a 2.8% Medicare rate increase in fiscal 2023. That would increase payment by $170 million compared to fiscal 2022 if CMS finalizes its proposal, which is based primarily on inflation.

CMS also asks for feedback on potentially including home health in the inpatient rehab transfer payment policy, as was recommended by the Health and Human Services’ Office of Inspector General. Medicare could have saved $993 million in 2017 and 2018 if it had implemented such a policy, OIG found.

CMS will examine home health claims to see whether this change is appropriate and wants comments to help shape the analysis and future rulemaking.

Additionally, CMS proposes to expand the inpatient rehab facility quality data reporting requirements to all patients, regardless of payer. The requirements currently apply to patients with Medicare Part A fee-for-service coverage and Medicare Advantage coverage, but expanding the reporting would help make sure all patients get the same quality of care and that provider metrics show performance across patients. If finalized, this would go into effect in fiscal 2025, meaning providers would need to start collecting patient assessments on all patients starting Oct. 1, 2023.

CMS seeks comments on whether it should add a digital quality measure for inpatient rehabilitation facilities that tracks new Clostridium difficile infection among patients already admitted to facilities. C. diff is an infection-causing bacteria that most commonly affects older adults in hospitals and long-term care facilities. This would be the first digital measure in the inpatient rehabilitation facility quality reporting program if finalized, according to CMS.

Inpatient psychiatric facilities could see a 1.5%, or $50 million increase, under CMS’ proposal.

The agency also wants comments on goals and approaches for measuring healthcare disparities across CMS quality programs, guiding principals for social risk factor and demographic data selection and other health equity considerations. Comments will inform equity efforts across behavioral health initiatives and in the inpatient psychiatric facility quality reporting program.

CMS wants comments on measuring equity and healthcare quality disparities across CMS quality programs from the inpatient rehabilitation facility community.

CMS proposed capping annual decreases on wage indices for both provider types at 5% to smooth year-to-year transitions. The agency suggested the same policy for hospices in a Wednesday notice.

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