Authored by Erin Shvetzoff Hennessey, Vice President, Business Solutions
Congress passed the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act), a bipartisan bill, on September 18, 2014, and it was signed into law on October 6, 2014. The bill was sponsored by Rep. Dave Camp [R-MI-4] and was co- sponsored by Rep. Sander Levin [D-MI-9], Rep. Kevin Brady [R-TX-8], Rep. Jim McDermott [D-WA-7], Rep. Earl Blumenauer [D-OR-3], Rep. Don Kind [D-WI-3], Rep. Patrick Tiberi [R-OH-12], Rep. Diane Black [R-TN-6], and Rep. Linda Sanchez [D-CA-38].
The House Ways and Means and Senate Finance Committees stated, “The IMPACT Act is the core building block needed for future Medicare PAC reforms, leading to more accountable, quality-driven services.”
The IMPACT Act requires the submission of standardized data by post-acute care (PAC) settings, including skilled nursing facilities (SNFs), home health agencies (HHAs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs). The statute requires: development of uniform quality and resource measures; a core set of assessment items across settings; and, detailed timelines and objectives. These requirements provide data uniformity, improved care and outcomes, the ability to compare quality and data across care settings, improved acute care discharge planning, and the sharing of data to improve care coordination. Assessment items include:
Over 5.5 million Medicare enrollees are served in PAC settings and over 42 percent of Medicare fee-for-service beneficiaries are discharged from acute care to PAC:
Implementation of the IMPACT Act comprises five parts:
Key implementation milestones include:
The escalating cost of post-acute care, combined with lack of uniform data and reporting across post-acute care, has created a focus on reduction of post-acute care spending. The goals of the IMPACT Act are to improve clinical outcomes and reduce Medicare expenses through an interoperable core data site, site-neutral payment policies, value-based payment approaches, and improved care transition and discharge planning.