CMS Posted Medicare Spending Per Beneficiary—Post Acute Care Resource Use Measures Specifications
January 15, 2016 03:48 PM
The Centers for Medicare and Medicare Services (CMS) has posted the measure specifications for the Medicare Spending Per Beneficiary — Post Acute Care (MSPB-PAC) Resource Use Measures.
The Improving Post-Acute Care Transformation Act of 2014 (IMPACT Act) authorizes the Secretary to develop “resource use measures, including total estimated Medicare spending per beneficiary” and to require the reporting of standardized assessment data in post-acute care (PAC) settings: skilled nursing facilities (SNFs), home health agencies (HHAs), long-term care hospitals (LTCHs), and inpatient rehabilitation facilities (IRFs). The MSPB-PAC measures must be implemented according to the following statutorily mandated timelines: October 1, 2016 for SNF, LTCH, and IRF Quality Reporting Programs (QRPs), and January 1, 2017 for the HHA QRP.
The purpose of the MSPB-PAC measures is to support public reporting of resource use in all four PAC provider settings as well as to provide actionable, transparent information to support PAC providers’ efforts to promote care coordination and improve the efficiency of care provided to their patients.
The National Association for Home Care & Hospice has expressed concern regarding using the MSPB as a quality measure. The amount of MSPB does not have a direct correlation with the quality of care provided by a home health agency. Although MSPB may provide some useful information on resource utilization of Medicare providers, it should not be used as the sole resource use measure or to draw assumptions on quality of care on its own. In addition, using MSPB as a quality measure could negatively impact access to home health care for certain high risk patient populations as providers are incented to avoid “high cost” patients in order to achieve favorable scores on the measure.
To view the MSPB measure specifications click here and scroll to the “Downloads” section. Comments are due January 27, 2016.