A post-acute common pay system possible, CMS says

Federal researchers believe a common evaluation and payment model for three types of post-acute care could be up and running in the not-so-distant future. The key might be patient acuity measures that aren’t currently used, they said.

Providers and other stakeholders who have struggled to find common touch points among skilled nursing facilities, long-term care hospitals and inpatient rehabilitation facilities welcome the idea.

The researchers base their conclusions upon findings of the Post Acute Care Payment Reform Demonstration, which involved 140 general acute and post-acute care providers. The Centers for Medicare & Medicaid Services project employed a new assessment instrument, the CARE Tool (Continuity Assessments Record and Evaluation).

“The implementation of CARE within the demonstration was successful,” said a February CMS report. “All five settings were able to use CARE to collect information in a consistent, reliable, and comprehensive manner for their Medicare populations.”

Researchers said that the “promise of the CARE tool,” combined with the importance of standardizing information collected between settings, means CMS “should pursue its development efforts towards integrating CARE into the reporting requirements” for SNFs, acute care hospitals, home health agencies, inpatient rehabilitation facilities and long-term care hospitals.

Developing case-mix systems using uniform definitions and measures between different settings “can be accomplished with a limited set of common patient acuity items. [Post-acute care] payment systems can be improved by the inclusion of patient acuity measures that are not included in current payment systems,” they observed.