If y
ou’re not familiar with the Improving Medicare Post-Acute Care Transformation (IMPACT) Act yet, it’s time to get up to speed. The Centers for Medicare & Medicaid Services (CMS) is moving forward with its implementation – and it could mean significant changes for post-acute facilities. In particular, nursing facilities and home health agencies could see changes around the use of quality rankings and how they discharge patients to other levels of care.
An Overview of the IMPACT Act
IMPACT’s intent is to facilitate better handoffs for patients from setting to setting and provide a framework to qualify patient care across the continuum. A number of proposed changes to the CMS Conditions of Participation (CoP) are preparing for its rollout. Those proposed changes focus on new discharge planning requirements for all care settings.
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What does it mean for skilled nursing facilities or home health agencies?
Referring organizations (especially hospitals and nursing facilities) will now need to use quality ratings when discharging patients to other levels of care. CMS recommends using Nursing Home Compare and Home Health Compare until another set of measures is available.
Another anticipated change requires post-acute providers to augment their discharge planning activities. Additional proposed changes include:
a person-centered care plan that assesses patients’ potential for discharge,
the inclusion of a medication reconciliation process and list in the patient’s discharge summary, and
a post-discharge follow-up addressed in the discharge plan of care.
What does this mean for patient choice?
CMS has been clear that patient choice is not going away – but it is getting easier to create preferred and narrow networks for referral partners. Many hospitals have already begun the process of “narrowing” their networks based on CMS star ratings. The proposed updates to the CoP continue to highlight the use of quality ratings in “informed” patient choice.
What are the takeaways?
Hospitals and other referral and transition sources will leverage quality data more in helping patients decide which nursing facility to choose. Monitoring the star rating performance will be key to receiving referrals from upstream providers.
The discharge planning process for skilled nursing facilities and home health agencies will be more complicated as CMS continues to focus on “good” handoffs from setting to setting. Looking for ways to increase efficiency for discharge planning activities will be crucial in meeting the new regulations.
