Two congressional committees have collaborated on draft legislation that could revolutionize the way post-acute care is assessed, delivered and paid for. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) offers a mixed bag of solutions, tools and processes intended to bridge the gaps in the way post-acute care, especially Medicare-based post-acute care, is currently utilized.
The bill, a joint project of the Senate Finance and the House Ways and Means committees, follows a year-long ingathering of comments and ideas from the post-acute care industry stakeholders.
One of the primary issues addressed by the bill is the need for a standardized way to assess post-acute care, a lacunae that the Medicare Payment Advisory Commission (MedPAC) has been discussing since 2005. Much of the challenge has centered on a lack of common data sets, which has made it nearly impossible for the post-acute care industry to analyze historical data on utilization, spending and service value margins, among other things. If adopted, the IMPACT Act would require post-acute providers to gather and report on common data sets, including hospital discharge data and resident status assessment at intake.
Bundled payments are here to stay, and the legislation also explores other models, such as value-based purchasing and site-neutral payments. In addition, MedPAC would then be required to analyze the data sets from across the industry and develop “payment prototypes” based on the assessment data.
The first key date would be 2017, when post-acute providers would begin required, standardized reporting on care quality and resource use. The bill sets 2019 as the proposed start date for the use of standardized assessment data for post-acute care.
Read the proposed legislation.