08/22/2018

SNF VBP Incentive Payment Multiplier Examples

Beginning FY2019 (October 1, 1018) the SNF VBP program will reduce the adjusted federal per diem rate for a fiscal year under Medicare by two percentage points and then redistribute 60% of the total amount of those reductions to SNF’s based upon the result of their performance score. (The higher of the SNF VBP Achievement Score or SNF VBP Improvement Score.) 

Below are some examples of how the Incentive Payment Multiplier will impact your Medicare payments. Your incentive payment multiplier can be found on your facility’s annual performance score report, which is now available on the QIES system.

• Incentive Payment Multiplier of .98 or less is 2% reduction (2% withhold for all Medicare FFS payments and then 0% incentive payback for net payment reduction of 2%)
• Incentive Payment Multiplier of .985 (2% withhold for all Medicare FFS payments and then .5% incentive payback for a net payment reduction of 1.5%)
• Incentive Payment Multiplier of .99 (2% withhold for all Medicare FFS payments and then 1% incentive payback for a net payment reduction of 1%)
• Incentive Payment Multiplier of 1.0 (2% withhold for all Medicare FFS payments and then 2% incentive payback for a net payment reduction of 0%)

Incentive Payment Multiplier of 1.01 (2% withhold for all Medicare FFS payments and then 3% incentive payback for a net payment addition of 1%)