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 IMPACT Act Nears House Vote

The U.S. House on Tuesday may take up legislation that advocates hope will create uniform standards for measuring quality health care—and, potentially, a site-neutral payment system.

The Improving Medicare Post-Acute Care Transformation Act of 2014, better known by its nom de guerre, the IMPACT Act, aims to help Medicare regulators create a common language and common measurements for rehabilitative quality. Currently, the different sectors of post-acute care each have their own weights and measures, and advocates (and policymakers) have long despaired of making sense of it all.

House Republicans are hoping to bring IMPACT up for a vote on the suspension calendar. Bills that are thought to be noncontroversial are often placed under suspension; it limits debate on the measure and prohibits amendments or riders from being tacked on.

The danger, though, is that anything on the suspension calendar has to be approved by a two-thirds majority on the floor.

Long term and post-acute care advocates will watch Tuesday’s action closely: Many, including the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), have endorsed the bill and hope to see it move quickly into law.

“Assessing improvement in areas such as functional outcomes, pressure ulcers, dementia, etc., goes a long way toward improving the health and well-being of our patients,” AHCA/NCAL President and Chief Executive Officer Mark Parkinson said in a letter to congressional leaders earlier this summer.

Parkinson and others also say they’re cheered by language in the bill that would require regulators to make providers’ quality measures public—a la Nursing Home Compare today—but also would require quality ratings to be given to patients and their families before they’re released to post-acute care providers. “This vital information will only help patients and family members with the very personal and anxious decision they face after being discharged from an acute-care setting,” Parkinson’s letter says.

It’s not just IMPACT’s immediate reforms that have caught provider advocates’ eyes.

“Finally, we are encouraged that this legislation moves us as a profession toward a more balanced, site-neutral payment model,” Parkinson’s letter said. “Currently, the Medicare system reimburses each type of … provider according to different payment methodologies. Existing payment policies focus on phases of a patient’s illness defined by a specific service site, rather than on the characteristics or care needs of the patient. As a result, patients with similar clinical profiles may be treated in different settings at different costs to Medicare. The IMPACT Act goal to use measures in payment models—as well as how to risk-adjust for those measures—should be applauded.”

If the bill is passed in the House, it will move to the Senate. Its main backers in the House are Ways & Means Committee Chairman Dave Camp (R-Mich.) and committee Ranking Member Sander Levin (D-Mich.). On the Senate side, Finance Committee Chairman Ron Wyden (D-Ore.) and Ranking Member Orrin Hatch (R-Utah) are IMPACT’s shepherds.

Bill Myers is Provider’s senior editor. Email him at wmyers@providermagazine.com. Follow him on Twitter, @ProviderMyers

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