Medicare Payment Policy

skilled nursing facility
services
Chapter summary
Skilled nursing facilities (SNFs) furnish short-term skilled nursing and
rehabilitation services to beneficiaries after a stay in an acute care hospital.
In 2011, almost 15,000 SNFs furnished Medicare-covered care to 1.7 million
fee-for-service (FFS) beneficiaries during 2.4 million stays. The Office of
the Actuary estimates that Medicare spending for 2011 was $31.3 billion and
comprised about 6 percent of Medicare’s spending.
Assessment of payment adequacy
To examine the adequacy of Medicare’s payments, we analyze access to care
(including the supply of providers and volume of services), quality of care,
provider access to capital, and Medicare payments in relation to providers’
costs to treat Medicare beneficiaries. Indicators of payment adequacy for
SNFs were positive. With regard to our assessment of efficient providers,
we base our findings on data from each of the past three years, as cost report
data for 2011 were not available at the time of our analysis. We were able to
identify facilities that furnished relatively high quality and had relatively low
costs compared with other SNFs and had high Medicare margins, suggesting
that opportunities remain for other SNFs to achieve greater efficiencies
without losing Medicare revenue.
Beneficiaries’ access to care—Access to SNF services remains stable for
most beneficiaries.
C H A p t e R 8
In this chapter
• Are Medicare payments
adequate in 2013?
• How should Medicare
payments change in 2014?
• Medicaid trends
Report to the Congress: Medicare Payment Policy | March 2013
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