IMPACT Act Highlighted At Health Information Technology Conference
Jackie Oberst
6/25/2015
Much headway has been made in the six months since the
Improving Medicare Post-Acute Care Transformation (IMPACT)
Act became law, report representatives from the Centers for Medicare &
Medicaid Services (CMS) this week at the 2015 Long-Term and Post-Acute Care (LTPAC) Health
IT Summit in Baltimore.
The bipartisan law will standardize quality assessments for
critical care issues across the spectrum of post-acute care providers such as long
term care hospitals, skilled nursing centers, home health agencies, and
inpatient rehabilitation facilities. These streamlined measures will facilitate
the comparison of outcomes across these four PAC settings, allow for
interoperability, and enable coordinated longitudinal care for Medicare
patients.
“There has been a monumental crossing of bridges to bring
together years of work,” said Stacy Mandl, RN, BSN, BSW, PHN, deputy division
director, Division of Chronic and Post-Acute Care (DCPAC), CMS.
The current state of health care can be likened to a
hospital that uses different assessment data tools for each unit—a nurse trying
to receive patients cannot simply communicate through electronic health
records, said Mandl. She elaborated that because communication among providers
is not standardized, providers often double- and triple-document survey data,
which comes at great time and staff expense.
“The IMPACT Act has very aggressive timelines,” said
Mandl. All four PAC settings must have the required measures
in place according to provider type and measure
domain type, with the earliest of such specified dates being Oct.
1, 2016. All four settings must report standardized
data using the assessment instruments on at least five of the following eight quality measure domains: functional
status, cognitive function, 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. Standardized
data in patient assessment domains are also required, and Long-term Care
Hospitals, Inpatient Rehabilitation Facilities and Skilled Nursing Facilities
are required to being reporting such assessment domain data standardized
data to CMS starting Oct. 1, 2018, and
for Home Health Agencies, January 1, 2019.
“Measures must be standardized across all four settings,”
says Tara McMullen, MPH, PhD, with the CMS Quality Measures & Health
Assessment Group. “We’re trying to get the ‘sweet spot’ of where all the data
analyses for all four settings converge.”
ina Gonzaga, MSN, RN, detailed the data standardization
process. Reusable templates for clinical and quality data are being created
such that the headers of the documents remain consistent but the bodies of the
texts are more dynamic.
Additionally, CMS is creating an assessment data library for
the public. It will house the assessment data that are currently collected via
various mechanisms: CARE tool, OASIS, MDS, LCDS, and IRF-PAI.
Jennie Harvell, MEd, who is interning at CMS’ DCPAC, said that the library will be implemented in
phases, with the first phase to come this fall.
Jackie Oberst is Provider’s managing editor. Email her at
joberst@providermagazine.com or follow her on Twitter, @Prov
iderMag.