Recently introduced legislation to standardize data used across postacute care settings is expected to move quickly through Congress, with a final vote likely to be held this summer. APTA has been working to influence this legislation and will continue to monitor its progress.

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (H.R. 4994/S. 2553) was introduced in both the House and Senate on June 26 by Senate Finance Chairman Ron Wyden (D-OR) and Ranking Member Orin Hatch (R-UT), and Ways and Means Chairman Dave Camp (R-MI) and Ranking Member Sander Levin (D-MI). If it becomes law, IMPACT would instruct the US Department of Health and Human Services (HHS) to standardize patient assessment data, quality, and resource use measures for PAC providers including home health agencies (HHAs), skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs).

Supporters of the legislation, which include APTA, believe standardization would allow HHS to compare quality across PAC settings, improve hospital and PAC discharge planning, and use this standardized data to reform PAC payments in the future. APTA and other stakeholders have been providing feedback on the legislation since August 2013.

If passed, the legislation would:

• Require PAC providers to begin reporting standardized patient assessment data at times of admission and discharge by October 1, 2018, for SNFs, IRFs, and LTCHs and by January 1, 2019, for HHAs.
• Require new quality measures on domains beginning October 1, 2016, through January 1, 2019, including functional status, skin integrity, medication reconciliation, incidence of major falls, and patient preference regarding treatment and discharge.
• Require resource use measures by October 1, 2016, including Medicare spending per beneficiary, discharge to community, and hospitalization rates of potentially preventable readmissions.
• Require the Secretary of HHS to provide confidential feedback reports to providers. The Secretary will make PAC performance available to the public in future years.
• Require MedPAC and HHS to study alternative PAC payment models due to Congress in 2016 and 2021-2022, respectively.
• Require the Secretary to develop processes using data to assist providers and beneficiaries with discharge planning from inpatient or PAC settings.

The congressional committees have provided a summary (.pdf), including timelines. APTA will continue to work with legislators and the committees to move this legislation forward.