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IMPACT Act Cheat Sheet by

care     medicare     healthcare     ltc     impact     improving     act     transformation     post-acute


In October 2014, the bipartisan Improving Medicare Post-Acute Care Transf­orm­ation (IMPACT) Act became law. This legisl­ation is an important step forward in improving the quality of health care for millions of Americans, providing consumers and government critical inform­ation regarding outcomes and cost. IMPACT will standa­rdize assess­ments for critical care issues across the spectrum of post-acute care (PAC) providers and builds a bridge to ensure that patient care is delivered based on what the patient needs, elimin­ating the silo focused approach to quality measur­ement and resource utiliz­ation.

How it works

The IMPACT Act has five parts:

1. Incorp­orate standa­rdized assess­ment, including components of the CARE tool, into existing assessment tools across PAC providers: skilled nursing facilities (SNF), long term care hospitals (LTCH), inpatient rehabi­lit­ation facilities (LTC), and home health agencies (HHA). This tool will measure quality based on a variety of metrics: pressure ulcers, functional status, cognitive status, and special services.
• Data will be collected at admission and discharge.
• Implem­ent­ation begins October 2018 (fiscal year 2019).

Develo­pment and public reporting of quality measures across settings, including hospit­ali­zat­ions, rehosp­ita­liz­ations, rehosp­ita­liz­ations after discharge from PAC provider, discharge to community, pressure ulcers, medication reconc­ili­ation, incidence of major falls, patient prefer­ences, and average total Medicare cost per benefi­ciary.
• Any measures must be approved by National Quality Forum or through notice and comment rulema­king.

3. Hospitals and PAC providers are required to provide quality measures to consumers when transi­tioning to a PAC provider. Conditions of partic­ipation are modified to incorp­orate Quality Measures (QMs) into the discharge planning process.
• There is a market basket payment penalty of 2% for failure to effect­ively collect and report data.

4. Requires HHS and MedPAC to conduct studies and reports to link payment to quality. HHS and MedPAC must develop a plan to link Medicare PAC payment to quality of care, review current risk adjustment method­olo­gies, and study the effect of benefi­cia­ries’ socioe­conomic status on quality, resource use, and other measures.

5. Adds $11M in funding for CMS to use payroll data to measure staffng in SNF setting.



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