IMPACT Act Resources 

Blueprint for Success on IMPACT Act Measures for Home Health

 

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 standardizes many elements of patient assessment across post-acute care settings, and requires reporting of standardized performance measures.  The IMPACT Act requirements apply to Long Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs, Inpatient Rehabilitation Facilities (IRFs), and Home Health Agencies (HHAs).

 

Use the links embedded in the Table below to click through to VNAA’s Best Practice information specific to each condition or topic.  Not all items currently have links.  More details about the IMPACT Act, and links to further information from the Centers for Medicare and Medicaid services are below. 

 

 

What is the IMPACT Act?

 

According to CMS, the purpose of the IMPACT ACT is to:

·         Improve Medicare beneficiary outcomes

·         Increase provider access to longitudinal information to facilitate coordinated care

·         Enable comparable data and quality across PAC settings

·         Improve hospital discharge planning

·         Facilitate research on programs and practices that improve outcomes.

 

Assessment domains to be standardized across PAC providers include:

·         Functional status

·         Cognitive function and mental status

·         Special services, treatments, and interventions

·         Medical conditions and co-morbidities

·         Impairments

·         Other categories required by the Secretary

 

Performance measures are classified as either quality or resource use.  The required measures include:

 

Quality Measure Domains:

·         Skin integrity and changes in skin integrity;

·         Functional status, cognitive function, and changes in function and cognitive function;

·         Medication reconciliation;

·         Incidence of major falls;

·         Transfer of health information and care preferences when an individual transitions;

Resource Use and Other Measure Domains:

·         Resource use measures, including total estimated Medicare spending per beneficiary;

·         Discharge to community; and

·         All-condition risk-adjusted potentially preventable hospital readmissions rates.

 

Implementation

 

CMS will be phasing in reporting of the IMPACT Act measures, with the goal of eventually reporting measure results to the public.  CMS’s proposed timeline is shown in the table below.

 

HHA Implementation Steps and Timeline for Impact Act Measures

Type of Measure

HHA reporting begins

Confidential Feedback Reports to Providers

Preview Reports to HHAs for Review

Public Reporting

Estimated Medicare Spending per Beneficiary

January 1, 2017

January 1, 2018

October, 2018

January 1, 2019

Discharge to community

January 1, 2017

January 1, 2018

October, 2018

January 1, 2019

All condition risk adjusted potentially preventable hospital readmission rates

January 1, 2017

January 1, 2018

October, 2018

January 1, 2019

Skin Integrity and changes in skin integrity

January 1, 2017

January 1, 2018

October, 2018

January 1, 2019

Medication reconciliation

January 1, 2017

January 1, 2018

October, 2018

January 1, 2019

 

 

 

 

 

Incidence of major falls

January 1, 2019

January 1, 2020

October, 2020

January 1, 2021

Communicating the existence of and providing for the transfer of health information and care preferences

January 1, 2019

January 1, 2020

October 2020

January 1, 2021

Functional status, cognitive function, changes in function and cognitive function

January 1, 2019

January 1, 2020

October, 2020

January 1, 2021

Use of Standardized Assessment data in required areas

October 1, 2018

NA

NA

No later than January 1, 2019

 

RESOURCES

 

IMPACT Act Information

 

Video: Introduction to the Improving Medicare Post-Acute Care Transformation Act of 2014 1/8/16  Moderated by Dr. Patrick Conway, CMS Principle Deputy Administrator and Chief Medical Officer.

 

CMS Presentation on the IMPACT Act, October 2015

 

Home Health Quality Initiative (CMS website with links to many initiatives)

 

OASIS C2 Information and Manual

The C2 version of OASIS includes standardized items needed to report new IMPACT Act measures

 

CMS Quality Measures

This page will have links to the most recent versions of measures in use for Home Health, including information on proposed regulations to add or retire measures.

 

CMS Measures Management

This page includes information on CMS measurement priorities, links to public comment opportunities, and other information on performance measures. 


CMS Home Health Quality Reporting Training: Archived slides and information from November, 2016 training hosted by CMS to improve home health quality reporting capability.

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