Common pay system for three post-acute care settings appears doable, new report says

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Relief could be on the horizon for providers, regulators and other stakeholders who have struggled to find common evaluation and payment models for individuals who move between post-acute care settings, researchers say.

Study results indicate a common pay system for skilled nursing facilities, long-term care hospitals and inpatient rehabilitation facilities could be built, they add. They 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 recently released CMS report on it. “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.

The development of case-mix systems using uniform definitions and measures of patient acuity 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.

Click here to read the full CMS report.

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