IMPACT Act Spotlights and Announcements

 

Upcoming Events and Updates

July 07, 2022

Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care

Section 2(b)(2)(A) of the Improving Post-Acute Care Transformation (IMPACT) Act of 2014 requires a report to Congress on unified payment for Medicare post-acute care (PAC).  Medicare PAC services are provided to beneficiaries by PAC providers defined as skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), long-term care hospitals (LTCHs), and home health agencies (HHAs).  Each PAC provider setting has a separate Medicare fee-for-service (FFS) prospective payment system (PPS). A goal of unified PAC payment is to base the payment on patient characteristics instead of the PAC setting. 

The Centers for Medicare and Medicaid Services (CMS) and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) contracted with Research Triangle Institute (RTI) to provide analysis for this study and report.  RTI convened external technical expert panel meetings to obtain input on the study and report.  In the report, the framework applies a uniform approach to case-mix adjustment across Medicare beneficiaries receiving PAC services for different types of PAC providers while accounting for factors independent of patient need that are important drivers of cost across PAC providers.  The unified approach to case-mix adjustment includes standardized patient assessment data collected by the four PAC providers.  The report does not include legislative recommendations, as additional analyses would need to be done prior to testing or universal implementation of a unified PAC payment system.

November 08, 2019

Specifications for the quality measures and standardized patient assessment data elements for the HH QRP as finalized in the CY 2020 HH PPS Final Rule are now posted.

In addition, the new and modified sections of the OASIS, along with a change table, effective January 1, 2021 for the measures and standardized patient assessment data elements finalized for the HH QRP in the CY 2020 HH PPS Final Rule can be found on the IMPACT Act Downloads and Videos webpage at /medicare/quality-initiatives-patient-assessment-instruments/post-acute-care-quality-initiatives/impact-act-of-2014/impact-act-downloads-and-videos

The Final Rule is available at https://www.federalregister.gov/.

November 01, 2019

Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test – Now Available 

The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to identify and develop standardized patient assessment data elements (SPADEs) for use in the following post-acute care (PAC) patient assessment instruments: the Outcome and Assessment Information Set, used in home health agencies; the Inpatient Rehabilitation Facility Patient Assessment Instrument, used in inpatient rehabilitation facilities; the Long-Term Care Hospital Continuity Assessment Record and Evaluation Data Set, used in long-term care hospitals; and the Minimum Data Set, used in nursing homes and skilled nursing facilities. 

RAND was tasked with developing and testing data elements within five areas of focus that fall under the clinical categories delineated in the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: (1) cognitive function and mental status; (2) special services, treatments, and interventions; (3) medical conditions and comorbidities; (4) impairments; and (5) other categories. This eight-volume report presents background information and results of the National Beta Test, which assessed a set of data elements within the five categories under the IMPACT Act. The eight volumes of the report are now available on the IMPACT Act Downloads and Videos webpage.

October 04, 2019

TEP Summary Report for Development of Functional Outcome Quality Measures for Long-Term Care Hospitals (LTCHs) is Now Available

The Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International to develop Functional Outcome Measures for Long-Term Care Hospitals (LTCHs). As part of its measure development process, CMS asks contractors to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure contractor during measure development and maintenance. On behalf of CMS, RTI International convened a Technical Expert Panel (TEP) on August 19, 2019, in Baltimore, MD seek expert input on the development of Functional Outcome Measures for LTCHs.

 The TEP summary report for the Development of Functional Outcome Quality Measures for Long-Term Care Hospitals (LTCHs) is now available on the IMPACT Act Downloads and Videos webpage. The report provides a summary of the TEP proceedings, detailing key issues of measure development and TEP discussion around those issues.

September 04, 2019

TEP Summary Report for Refinement of a Cross-Setting Pressure Ulcer/Injury Quality Measure for Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, Long-Term Care Hospitals, and Home Health Agencies is Now Available

The Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International and Abt Associates to develop quality measures reflective of quality of care, resource use, and other measures for post-acute care (PAC) settings to meet the mandate of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) and support CMS quality initiatives. As part of its measure development process, CMS asks contractors to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure contractor during measure development and maintenance. On behalf of CMS, RTI International and Abt Associates convened a Technical Expert Panel (TEP) on June 13, 2019, in Baltimore, MD to seek expert input on expert input on the refinement of risk adjustment models for the quality measure, Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury for Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), and Home Health Agencies (HHAs). 

The TEP summary report for the Refinement of a Cross-Setting Pressure Ulcer/Injury Quality Measure for Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, Long-Term Care Hospitals, and Home Health Agencies is now available on the IMPACT Act Downloads and Videos webpage. The report provides a summary of the TEP proceedings, detailing key issues of measure development and TEP discussion around those issues.

August 02, 2019

Specifications for the quality measures and standardized patient assessment data elements for the SNF QRP, IRF QRP, and LTCH QRP as finalized in the FY 2020 SNF PPS Final Rule, FY 2020 IRF PPS Final Rule, and FY 2020 IPPS/LTCH PPS Final Rule respectively are now posted.

In addition, the new and modified sections of the MDS, IRF-PAI, and LTCH CARE Data Set, along with a change table, effective October 1, 2020 for the measures and standardized patient assessment data elements finalized for the SNF QRP, IRF QRP, and LTCH QRP in the FY 2020 SNF PPS Final Rule, FY 2020 IRF PPS Final Rule, and FY 2020 IPPS/LTCH PPS Final Rule respectively can be found on the IMPACT Act Downloads and Videos webpage at /medicare/quality-initiatives-patient-assessment-instruments/post-acute-care-quality-initiatives/impact-act-of-2014/impact-act-downloads-and-videos

The Final Rules are available at https://www.federalregister.gov/.

July 11, 2019

Specifications for the quality measures and standardized patient assessment data elements for the HH QRP as proposed in the CY 2020 HH PPS Proposed Rule are now posted.

In addition, the new and modified sections of the OASIS, along with a change table, effective January 1, 2021 for the measures and standardized patient assessment data elements proposed for the HH QRP in the CY 2020 HH PPS Proposed Rule can be found on the IMPACT Act Downloads and Videos webpage.

The Proposed Rules will be available at https://www.federalregister.gov/.

June 12, 2019

The PACIO Project (Post-Acute Care Interoperability), pronounced "passeeo", launched on February 26, 2019. The goal of this collaborative partnership is to establish a framework for the development of a Fast Healthcare Interoperability Resource (FHIR) technical implementation guide(s) and Reference Implementations that will facilitate health information exchange through standards-based application programming interfaces (APIs). The objective of the PACIO Project is to use a consensus-based approach to advance interoperable health data exchange between post-acute care providers, patients, and other key stakeholders across the health care continuum with policy makers, standards organizations, and industry. This project is open to everyone, led by the MITRE Corporation, and participants include health IT vendors, providers, clinicians, researchers, standards organizations, CMS, ONC, and the VA.

The PACIO Project GitHub page, as well as additional information about FHIR, can be found at the links below:

• • Link to Project PACIO GitHub page
  • Link to HL7 FHIR Overview

To participate in the PACIO Project, please contact dwhill@mitre.org

 

June 12, 2019

Video Tutorials Available to Assist with Coding Specific Section GG Items

The Centers for Medicare & Medicaid Services is releasing a series of short videos to assist providers with coding select Section GG items on the OASIS, IRF-PAI, LTCH CARE Data Set, and the MDS. These videos, ranging from 4-12 minutes, are designed to provided targeted guidance using simulated patient scenarios. To access the videos, click on the links below:

• Coding GG0110. Prior Device Use with Information From Multiple Sources (3:58)

• Decision Tree for Coding Section GG0130. Self-Care and GG0170. Mobility (11:56)

• Coding GG0130B. Oral Hygiene (4:25)

• Coding GG0170C. Lying to Sitting on side of bed (4:33)

May 14, 2019 

The Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International to develop functional outcome quality measures for post-acute care (PAC) settings that meet the requirements of the IMPACT Act of 2014. As part of the measure development process, CMS requires that contractors convene groups of stakeholders and experts who contribute direction and thoughtful input to the contractor. RTI International, on behalf of CMS, will convene a 1 day in-person technical expert panel (TEP) in the summer of 2019, in Baltimore, Maryland, to seek input on the development of functional outcome quality measures for Long-Term Care Hospitals (LTCHs). For more information on the Development of Functional Outcome Quality Measures for Long-Term Care Hospitals (LTCHs) TEP, please visit the CMS Measure Management System Technical Expert Panel webpage at /Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TEP-Currently-Accepting-Nominations.

April 18, 2019

Specifications for the quality measures and standardized patient assessment data elements for the SNF QRP, IRF QRP, and LTCH QRP as proposed in the FY 2020 SNF PPS Proposed Rule, FY 2020 IRF PPS Proposed Rule, and FY 2020 IPPS/LTCH PPS Proposed Rule respectively are now posted.

In addition, the new and modified sections of the MDS, IRF-PAI, and LTCH CARE Data Set, along with a change table, effective October 1, 2020 for the measures and standardized patient assessment data elements proposed for the SNF QRP, IRF QRP, and LTCH QRP in the FY 2020 SNF PPS Proposed Rule, FY 2020 IRF PPS Proposed Rule, and FY 2020 IPPS/LTCH PPS Proposed Rule respectively can be found on the IMPACT Act Downloads and Videos webpage at /medicare/quality-initiatives-patient-assessment-instruments/post-acute-care-quality-initiatives/impact-act-of-2014/impact-act-downloads-and-videos

The Proposed Rules are available at https://www.federalregister.gov/.

March 13, 2019

The RAND Corporation, with representatives from the Centers for Medicare & Medicaid Services (CMS), hosted a meeting On November 27^th, 2018 in which they presented an overview of results from the National Beta Test of candidate standardized patient assessment data elements (SPADEs) and answered questions from attendees. Following the presentation, the meeting’s transcript and materials were made available and CMS invited the public to submit feedback to an email inbox. A verbatim comment summary report is now available the IMPACT Act Downloads and Videos page. CMS will not be responding to comments.

January 31, 2019

The Centers for Medicare & Medicaid Services (CMS) has contracted with the RAND Corporation to develop standardized patient assessment data elements for post-acute care (PAC) settings that meet the requirements of the IMPACT Act of 2014. As part of its item standardization development process, CMS requires that contractors convene groups of stakeholders and experts who contribute direction and thoughtful input to the contractor. The RAND Corporation, on behalf of CMS, convened a technical expert panel (TEP) on September 17, 2018, in Arlington, Virginia, to seek input on the development of standardized patient assessment data with a focus on Home Health Agencies (HHAs), Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), and Skilled Nursing Facilities (SNFs). See below for a list of individuals who participated as the technical experts for this project.

 

	Name, Credentials, Professional role	Organization Affiliation, City,State	PAC Setting (S)	Role/Area of Expertise
1	Susan Battaglia, RN-BC,RAC-C Director of Case Mix Management	Tara Cares: NGNA:AANAC Orchard Park, NY	SNF	Patient assessment, workforce, QI
2	Cheryl Burzynski, MSN President and Chief Nursing Officer	McLaren Bay Special Care, Bay City, MI	LTCH	Administrator:workforce
3	Daniel Butts, MOT, OTR/L, MBA Senior Director Rehabilitation Operations	UPMC Rehabilitation Network Pittsburgh, PA	IRF, LTCH, SNF	Administrator: workforce
4	Judy Elmore, BS Vice President, Ancillary Operations	Covenant Healthcare Aliso Viejo, CA	HH,SNF	Administrator: Workforce, QI, Health Information Technology
5	Janet Herbold, PT, MPH,CHC Senior Administrator and Corporate Compliance Officer	Burke Rehabilitation Hospital White Plains, NY	IRF	Provider/Administrator patient assessment, care transitions
6	Kathleen Lawrence, MSN, RN, CWOCN Wound Ostomy Continence Program Manager	Rutland Area Visiting Nurse and Hospice Rutland, VT	HH, IRF, LTCH, SNF	Provider: care preferences, pain, workforce
7	Natalie Leland, PhD, OTR/L, BCG, FAOTA Assistant Professor	University of Southern California; Los Angeles, CA	IRF, SNF	Care preferences, QI, HIT
8	Marc Rothman, MD Senior VP & Chief Medical Officer	Kindred Healthcare; Louisville, KY	HH, IRF, LTCH, SNF	Provider: QI, workforce, care transitions
9	Monica Sampson, PhD, CCC-SLP Associate Director	Health Care Services in SLP, Rockville, MD	SNF	Provider: hearing and vision assessment, assessment of cognitive function
10	Chloe Slocum, MD Physical Medicine and Rehabilitation Physician	Spaulding Rehabilitation Hospital, Sandwich, MA	HH, IRF	Provider: pain assessment, performance measurement, medication reconciliation
11	Peter W. Thomas, JD Principal	Powers Pyles Sutter & Verville PC; Washington, DC	HH, IRF, LTCH, SNF	Consumer
12	Barbara Thomsen, CDM, CFPP, RAC-CT MDS/Case Mix Audit Specialist and Quality Assurance	Hawkeye Care Centers, Norwalk, IA	HH, IRF, LTCH, SNF	Provider: patient assessment, performance measurement
13	Heidi Wald, MD Associate Professor	University of Colorado School of Medicine, Aurora, CO	SNF	QI, urinary and bowel
14	Michael Wasserman, MD, CMP Director, Nursing Home QIN-QIO	Health Services Advisory Group Glendale, CA	HH, LTCH, SNF	Provider:QI, care transitions
15	Kathleen Witcoskie, RN Vice President	Visiting Nurse Association of American Health Systems Shamokin, PA	HH, LTCH, SNF	Research/ academic:  QI, healthcare disparities
16	Kimber Zappia, BSW, MBA Executive Director	Carolinas Healthcare System Charlotte, NC	HH, IRF, LTCH, SNF	Administrator/provider: workforce, care transitions
17	Cheryl Phillips, MD* Senior VP Public Policy and Health Services	Leading Age Washington, DC	SNF,IRF, HH	Administrator: QI, performance measurement, patient assessment process
18	John Votto, DO, FCCP* President & CEO	Hospital for Special care, Inc. New Britain, CT	LTCH	Administrator: patient assessment, performance measurement

 

 

January 31, 2019

IMPACT Act Transfer of Health Information Measures: Pilot Test Summary Report Available

Pilot testing for the draft Transfer of Health Information measures took place June-August 2018. The measures are under development in order to meet the mandate of the IMPACT Act for the domain of "Transfer of health information and care preferences when an individual transitions".

View the pilot test summary report on the IMPACT Act Downloads and Videos webpage.

Please refer to the Archived Information webpage for announcements from early 2019 and earlier.

 

Archived Information