Access to Skilled Nursing Facilities
The National Hemophilia Foundation is very concerned that the current Medicare reimbursement for skilled nursing facilities (SNFs) is limiting access to these facilities for patients with hemophilia and other severe bleeding disorders following an inpatient hospital admission. Patients with hemophilia admitted to SNFs may need frequent infusions of clotting factor treatments to assist in their recovery with an estimated average cost of $10,000 per day. SNFs are reimbursed via a bundled payment that reflects the average costs of treatments, room/board and nursing for most patients, which is well below the costs incurred by people with bleeding disorders.
Under current law, Medicare pays separately for some high-cost services, such as chemotherapy and certain types of prosthetics that are not typically provided in the SNF setting. NHF is seeking legislation to add clotting factor therapies to the list of services paid for separately (in addition to the SNF bundled payment) when provided to patients being cared for in SNFs following a hospital stay. Authorizing additional Medicare payment for clotting factor therapies will increase access to quality, cost-effective treatment for patients with hemophilia and other bleeding disorders.