Policy Alert: Impact Act Signed

The President signed the Improving Medicare Post-Acute Transformation Act of 2014, bipartisan legislation that puts in place new and streamlined quality measures for nursing homes, home health agencies, and other post-acute care providers participating in Medicare.

The ACT will facilitate patients comparing outcomes across different care settings, supporting better choices and better outcome for patients. In addition, the IMPACT Act funds a key improvement to nursing home oversight, the collection of staffing data. Nursing and other staffing levels are closely correlated with quality in nursing homes and current data collection efforts have produced data of uneven reliability. The IMPACT ACT also institutes more routine surveys of hospice providers, ensuring program standards are met for the benefit and safety of patients.

“Even though the new reporting requirements will mean more work for us the legislation sets us up for payment changes that may include “site-neutral” payments meaning we will be paid for services provided, not just by the setting those services are provided in. Also this could help with the further development of bundled payments. Currently Medicare makes separate payments to providers for each of the individual services we provide for a single illness, this can result in fragmented care with a lack of collaboration across the continuum of providers in different healthcare settings,” Toni Lynn Davis MHA, CNHA, FACHCA, CEO/President Green Hill Inc. “Payment is for quantity of services offered rather than the quality provided. Bundled payments supports incentives for providers to work closely together across all settings. The changes will impact not just fee for service but also managed care Medicare and private insurances. Receiving higher payments for nursing acuity rather than just rehab is a big improvement. Improved quality and better payments for those who are providing more services will be noticed as standardized information will become the driving factor behind post-acute services.”

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