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From Health Law Daily, October 6, 2014

New law to make an ‘IMPACT’ on quality of post-acute care

By Patricia K. Ruiz, JD

CMS has announced major steps in quality improvement for post-acute care, including President Obama’s signature on the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (H.R. 4994) on October 6, 2014. CMS will also be undertaking efforts to enhance the validity of data on the Five-Star Quality Rating System (FSQRS) featured on the Nursing Home Compare website.

IMPACT Act. The IMPACT Act of 2014 amends title XVIII of the Social Security Act to: (1) require providers of post-acute care to report standardized patient assessment data, data on quality measures, and data on resource use and other measures; (2) require the data to be interoperable to allow for its exchange among post-acute care providers and other providers, giving them access information facilitating coordinated care and improved beneficiary outcomes; and (3) modify assessment instruments applicable to providers of post-acute care for the submission of standardized patient assessment data, enabling data comparison across providers. The IMPACT Act also requires HHS and the Medicare Payment Advisory Commission (MedPAC) to submit reports to Congress with recommendations for a new post-acute care payment system. Finally, the IMPACT Act requires HHS to create new regulations and process to improve the quality of care, as well as the ability of beneficiaries to make informed choices (see House and Senate take bipartisan action to modernize Medicare, post-acute care, March 20, 2014).

Nursing Home Compare. The biggest problem in tracking quality of care in post-acute settings is the reliance on self-reported data, according to CMS Deputy Administrator and Chief Medical Officer Dr. Patrick Conway in a press conference call. According to Conway, the improvements to the FSQRS, supported by the IMPACT Act, will improve the validity of data. The new FSQRS will expand the audit system nationally and will include staffing data (such as overall nurse and aide staffing, retention and turnover, and staffing mix). The IMPACT Act, in addition to creating standardized assessment data across post-acute care, also provides for penalties against providers who do not report quality data.

While the data collection improvements will make the ratings on Nursing Home Compare more valid, valuable, and usable, Conway said, current users of the website should not be skeptical of the ratings that are now shown. “Nursing Home Compare is an excellent starting point to begin those conversations about how to select a nursing home for your loved ones,” Conway said. He encouraged consumers to visit nursing homes and talk to staff, in addition to using the website ratings to find a good fit.

The improvements to Nursing Home Compare will begin in January 1, 2015, with the implementation of new quality measures and the expansion of the audit process throughout the nation. Creation of the system to collect more accurate data will also occur in 2015, with data collected throughout the year and reported in 2016, Conway said.

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