Standardized tool for assessing post-acute care is floated in House and Senate

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Sen. Ron Wyden (D-OR), chairman of the Senate Finance Committee
Sen. Ron Wyden (D-OR), chairman of the Senate Finance Committee

Lawmakers in both houses of Congress have unveiled a draft bill calling for post-acute care providers to furnish standard assessment data, with the goals of enabling better quality oversight and driving Medicare payment reform.

The Senate Finance and House Ways and Means committees on Tuesday introduced companion versions of the “Improving Medicare Post-Acute Care Transformation Act of 2014” (IMPACT Act).

Should the bill become law, the Minimum Data Set and other assessment instruments would be modified to enable different types of post-acute providers to submit standard data related to patient assessment, quality measures and resource use measures.

The patient assessment data would include such items as functional status, cognitive function and medical condition, according to the draft. Quality measures would include changes in skin integrity and incidence of major falls. Resource use measures would include total Medicare spending per beneficiary. Risk-adjusted rates of potentially preventable hospital admissions and readmissions also would be tracked as a resource use measure.

Skilled nursing facilities' quality reporting would kick off at the start of fiscal 2019 under the proposal. SNFs that fail to report mandated assessment data would have an additional 2 percentage points docked from the annual market basket update of Medicare rates.

The Medicare Payment Advisory Commission and the Department of Health and Human Services would use the first two years of IMPACT Act reporting data to create Congressional reports on potential payment reforms. Specifically, the draft bill calls for the agencies to draw up “recommendations and a technical prototype” of a post-acute payment system based on individual patient characteristics rather than the setting where care is provided.

The bill is largely based on input that lawmakers received from the post-acute provider community in 2013, according to a release from the two committees involved.

The draft is "thoughtful and promising" insofar as it paves the way for "patient-centered, quality based payments," said Greg Crist, senior vice president of public affairs at the American Health Care Association/National Center for Assisted Living, the nation's largest provider group.  

"We support uniform data collection across settings, use of quality measures across settings, and exploring new payment models," Crist said. "Throughout the process, we will work with Congress to ensure better care at lower cost.” 

Representatives of provider association LeadingAge are attending a briefing on the proposed legislation today, prior to responding publicly to the draft, spokeswoman Lauren Shaham told McKnight's.