CMS Holds IMPACT Act National Provider Call
October 23, 2015 03:51 PM
The Centers for Medicare & Medicaid Services (CMS) held a National Provider Call to inform stakeholder of its progress and plans related to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.
The IMPACT Act was signed into law in October 2014. The Act requires CMS to develop standardized assessment data and quality measures across the post acute care (PAC) settings that include inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), long term care hospitals (LTCHs) and home health agencies (HHA).
The act specifies both the domains and time frames for which each PAC provider must begin to submit the cross setting quality measures. The quality measure domains include functional status, cognitive function, and changes in functional and cognitive function; skin integrity and changes in skin integrity; medication reconciliation; incident of major falls; and communicating the existence of and providing for the transfer of health information and care preferences.
Resource use and other measures such as total Medicare spending per beneficiary, discharge to community, and potentially preventable hospital readmission rates are also part of the quality measures required by the IMPACT Act.
SNFs, IRFs, and LTCHs, must begin reporting select quality measures as early as October 1, 2016. HHAs must begin reporting measures related to changes in skin integrity, medication reconciliation and resource use beginning January 1, 2017.
CMS has been working to meet the deadlines for measure development. The following three measures have already been finalized for SNF, IRF and LTCH, and the measure for new or worsened pressure ulcers has been proposed for home health agencies in the 2016 home health prospective payment system rate update.
Percent of Residents/Patients/Persons with Pressure Ulcers That Are New or Worsened
Percent of Patients/Residents/Persons With an Admission and Discharge
Functional Assessment and a Care Plan that Addresses Function
Percent of Residents/Patients/Persons Experiencing One or More Falls with Major Injury
The act also requires CMS to develop standardized assessment data that address functional status; cognitive function and mental status; special services, treatments, and interventions; medical conditions and co-morbidities; impairments; and any other categories required by the Secretary.
In addition, to the specified assessment data categories, CMS must incorporate the standardized assessment data into the existing assessment tools currently used by each PAC provider. The Act outlines specified timeframes for which the data must be submitted by each of the PAC providers. For HHAs, the assessment data must be submitted beginning January 1, 2019. SNF, IRF, and LTCH must submit the assessment data not later than October 1, 2018.
CMS includes in the presentation the process for measure consideration and approval, along with several resource links to the CMS and National Quality Forum web sites. PAC stakeholders can keep abreast of the events surrounding implementing this very ambitious and complex project. In addition, CMS has a tentative schedule for upcoming provider outreach sessions such as special Open Door Forum calls.
NAHC encourages home health agencies to take advantage of the outreach opportunities in order to stay informed and engaged in activities towards implementing the IMPACT act. The quality measures and the assessment data developed as required by the IMPACT Act will have effects on home health agencies well into the future.