The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 mandates significant changes in how post-acute care providers collect and report data. This act introduced a crucial “care tool”—standardized patient assessment data—to improve the quality and coordination of care for Medicare beneficiaries. This article delves into the IMPACT Act, its core components, and how its mandated data collection process impacts post-acute care settings.
Standardized Data: The Core of the IMPACT Act Care Tool
The IMPACT Act requires Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs), and Inpatient Rehabilitation Facilities (IRFs) to submit standardized patient assessment data. This data collection utilizes established assessment instruments:
- LTCHs: Long-Term Care Hospital CARE Data Set (LCDS)
- SNFs: Minimum Data Set (MDS)
- HHAs: Outcome and Assessment Information Set (OASIS)
- IRFs: Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI)
This standardization, a key feature of the Impact Act Care Tool, enables interoperability, facilitating seamless data exchange between post-acute providers and other healthcare professionals. This shared information empowers better decision-making, enhances care coordination, and streamlines discharge planning, ultimately improving patient outcomes.
Key Domains and Categories of the IMPACT Act
The IMPACT Act focuses on specific clinical assessment domains and categories, requiring standardized data submission across all four post-acute care settings. These domains encompass:
Quality Measure Domains:
- Skin Integrity: Monitoring and managing skin conditions, particularly pressure ulcers.
- Functional Status and Cognitive Function: Assessing and tracking changes in patients’ physical and cognitive abilities.
- Medication Reconciliation: Ensuring accurate and up-to-date medication lists.
- Major Falls: Identifying and mitigating fall risks.
- Information Transfer: Facilitating seamless transfer of patient information and care preferences during transitions.
Resource Use and Other Measure Domains:
- Resource Utilization: Measuring and analyzing Medicare spending per beneficiary.
- Discharge to Community: Tracking successful discharges back to the community.
- Hospital Readmissions: Monitoring and reducing potentially preventable hospital readmissions.
Assessment Categories:
These categories provide a comprehensive framework for evaluating patient needs:
- Functional Status
- Cognitive Function and Mental Status
- Special Services, Treatments, and Interventions
- Medical Conditions and Co-morbidities
- Impairments
- Other categories as determined by the Secretary
IMPACT Act Measures and Their Application
The IMPACT Act outlines specific measures within each domain, applied across all participating post-acute care settings. These measures are detailed in a table within the Act itself, clearly outlining the specific data points to be collected and reported. This structured approach ensures consistency and comparability across different providers and settings. For example, tracking “Discharge to Community” provides valuable insights into the effectiveness of post-acute care in facilitating a successful transition for patients.
IMPACT Act and Meaningful Measures
The IMPACT Act directly supports the Centers for Medicare & Medicaid Services (CMS) “Meaningful Measures” initiative. This initiative prioritizes quality measurement and improvement, focusing on core issues crucial for delivering high-quality care. The alignment between the IMPACT Act and Meaningful Measures underscores the commitment to enhancing patient care through data-driven insights and targeted interventions.
The Data Element Library (DEL): Centralizing Information
The CMS Data Element Library (DEL) serves as a central repository for all assessment instrument data elements and associated health IT standards. It promotes data sharing and interoperability, further supporting the goals of the IMPACT Act.
Conclusion: The IMPACT Act’s Lasting Influence
The IMPACT Act, through its comprehensive data collection and standardization requirements, has significantly reshaped the landscape of post-acute care. By leveraging the power of standardized data, often referred to as its “care tool,” the Act promotes transparency, improves care coordination, and ultimately enhances the quality of life for Medicare beneficiaries transitioning through various care settings. The continued development and refinement of the IMPACT Act’s provisions promise ongoing improvements in post-acute care delivery.
