The Pain Interview for a new post-acute evaluation system, has been the most useful thus far, according to a progress report from federal officials on Wednesday.
That Pain Interview portion (4.25 out of a possible 5), Expression and Understanding (4.19), and Hearing and Vision (4.10) were the categories earning the highest average marks from providers.
Stakeholders received the update during a Centers for Medicare & Medicaid Services Open Door Forum call on the IMPACT Act.
Regulators are charged with establishing uniform reporting measures across skilled nursing and the rest of post-acute care. Doing so is required under the IMPACT (Improving Medicare Post-Acute Care Transformation Act) of 2014. The Centers for Medicare & Medicaid Services has contracted with the RAND Corp., which has been working to test the reliability and validity of possible data elements, and identify the best, most feasible subset of those elements to meet the requirements of IMPACT.
CMS hopes that such standardization will enable better comparisons of data across all post-acute settings — including nursing homes, home health, inpatient rehab and long-term care hospitals — and bolster coordination and discharge planning.
Beta testing started in 14 U.S. Markets late last year, as McKnight’s has reported. RAND and CMS experts provided a brief update and answered questions during Wednesday’s Open Door Forum phone call.
Officials said that out of 136 post-acute providers participating in the beta testing, 56 are of the skilled-nursing variety, submitting more than 1,400 assessments.
Usefulness, impact rated
RAND is working to test the feasibility and reliability of measures. About 36% of respondents work in SNFs.
Web-based surveys tied questions to whether measures had (1) clinical utility or (2) were burdensome to assessors and/or patients, (3) and to identify the factors that might impact providers’ ability to collect such data.
(1) Survey respondents were asked to rate measures on a scale of 1 to 5, with 1 representing “not at all useful” up to “extremely useful.” In the clinical utility segment, officials said, “pain interview” was rated among the best two across all settings. SNF assessors, meanwhile, rated “expression and understanding” highest.
(2) Under “burdensome” to assessors/patients, respondents also used a 1-to-5 scale, ranging from “not at all difficult” to “extremely difficult.” SNFs found pain interview, nutritional approaches, and SSTI most helpful.
(3) And finally, when quizzing on factors that impact data collection, time constraints (38%) and availability of data (32%) were most frequently named, across post-acute settings. SNF assessors, specifically, pointed to timing constraints as No. 1.
Results thus far are preliminary, officials emphasized. They’re holding focus groups with providers to tease out more details, and they plan to eventually publish a report on such SPADE (Standardized Patient Assessment Data Elements) testing. This is part of a three-year effort that launched in fall 2015, and is expected to conclude in September, according to CMS. RAND and the CMS also plan to host a “mini conference” at a yet-to-be-determined date to further discuss the results, officials said.
A recording of the conference call and the slide presentation can be found here.