Both houses of Congress now officially are considering bills to standardize assessments across various post-acute care provider types. The House Ways and Means and Senate Finance committees introduced companion versions of the “Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014” Thursday, after releasing a draft in March.
Skilled nursing facilities, inpatient rehabilitation facilities and other post-acute settings use a variety of assessment instruments, such as the Minimum Data Set and the IRF-Patient Assessment Instrument. The IMPACT Act calls changes to these instruments so that these providers can report standard data in a variety of areas, including functional status, cognitive function and prior function levels.
This standardized data would enable policymakers and providers to see “whether patients treated and the care provided in different settings is, in fact, the same or whether one PAC setting is more appropriate,” the two committees noted in a joint statement. These comparisons are to be used to implement post-acute payment reforms, the bill specifies.
Already, the Medicare Payment Advisory Commission and other groups have pushed for site-neutral payments, which would reimburse skilled nursing facilities and inpatient rehab facilities at the same rate for some services. The nation’s largest long-term care provider association supports the idea.
“Standardized post-acute assessment data are the necessary building blocks for any meaningful payment reform that would rationalize payments across PAC settings,” the American Health Care Association/National Center for Assisted Living stated in written testimony to the Ways and Means Committee earlier this month. The association urged Congress to “waste no more time” in passing the IMPACT Act.
The bill is based in large part on recommendations from post-acute providers that leaders of the House and Senate committees solicited last year. The Finance Committee is now led by Chairman Sen. Ron Wyden (D-OR) and Ranking Member Sen. Orrin Hatch (R-UT). Rep. Dave Camp (R-MI) is chairman of the Ways and Means Committee, and Rep. Sander Levin (D-MI) is ranking member.