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 CMS Educates Providers, Public On IMPACT Act, Eyes Participation From Hospices

The Centers for Medicaid & Medicare Services (CMS) held a teleconference meeting Wednesday for long term and post-acute care (PAC) providers that gave a basic overview of the timelines involved in implementing the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 as well as additional learning and public commentary opportunities. It also hinted that other health care programs, such as hospice, outpatient rehabilitation, and telehealth may eventually be incorporated into the act.
Passed on Sept. 18, 2014, and signed into law by President Obama on Oct. 6, 2014, the bipartisan bill will standardize quality assessments for critical care issues across the spectrum of post-acute care (PAC) providers such as long term care hospitals, skilled nursing centers, home health agencies, and inpatient rehabilitation facilities. These streamlined measures will improve across these four PAC settings the quality and outcomes of the health care provided, facilitate the comparison of quality and data outcomes, allow for interoperability, improve discharge planning, and enable coordinated longitudinal care for Medicare patients.
“The IMPACT Act allows us to collect data so information follows the person…as they go through the health care continuum,” said co-presenter Tara McMullen, MPH, PhD, with the CMS Quality Measures & Health Assessment Group, to the audience that comprised mainly providers from skilled nursing facilities, inpatient rehabilitation facilities, home health agencies, and their associated stakeholders. 
Added co-presenter Stacy Mandl, RN, BSN, BSW, PHN, deputy division director, Division of Chronic and Post-Acute Care (DCPAC), CMS: “Such valid information can facilitate patient care coordination. It will reduce provider burden with the idea of collect once, use more than one time.”
All four PAC settings must report standardized data using the assessment instruments on at least these five quality measure domains, with the earliest of such specified dates being Oct. 1, 2016: functional status, cognitive function, and changes in function and cognitive function; skin integrity and changes in skin integrity; medication reconciliation; incidence of major falls; and communicating the existence of and providing for the transfer of health information and care preferences.
Three other quality measure domains—total estimated Medicare spending per beneficiary, discharge to community, and measures to reflect all-condition risk-adjusted potentially preventable hospital readmission rates—also begin on Oct. 1, 2016, for skilled nursing facilities, inpatient rehabilitation facilities, and long term care hospitals, but on Jan. 1, 2017, for home health agencies.
“There will be all kinds of opportunities for engagement,” said Mandl. These opportunities include focus groups this fall, technical expert panels in the fall and winter, and alpha/beta testing in spring/fall 2016. A “Train the Trainer” event for long term care hospital providers  will be held on Nov. 19 and 20 as well as Open Door Forums (one for skilled nursing facilities and long term care on Oct. 29 and Dec 1; another for patients and families on Oct. 27). Future webinars and e-newsletters are also being planned.
The agency “anticipates alignment measures with hospice programs,” said McMullen to an audience question. Related questions to outpatient rehabilitation and telehealth were referred to An Open Door Forum that includes hospice programs, home health agencies, and durable medical equipment suppliers will be held on Nov. 4 and Dec. 16.
Jackie Oberst is Provider’s managing editor. Email her at or follow the magazine on Twitter @ProviderMag or @ProviderMyers.
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