1. Central Valley Care Transitions Collaborative
IMPACT ACT
Lindsay Holland, HSAG
May 17, 2016
Central Valley Care Transitions Collaborative

2. Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014
Submission Requirement:
Standardized Assessment Data
Facility Type
Software
Long-Term Care Hospitals (LTCHs)
LCDS
Skilled Nursing Facilities (SNFs)
MDS
Home Health Agencies (HHAs)
OASIS
Inpatient Rehabilitation Facilities (IRFs)
IRF-PAI
Requires the submission of standardized assessment data by:
Long-Term Care Hospitals (LTCHs): LCDS
Skilled Nursing Facilities (SNFs): MDS
Home Health Agencies (HHAs): OASIS
Inpatient Rehabilitation Facilities (IRFs): IRF-PAI
Requires that CMS make interoperable:
Standardized patient assessments
Quality measures data
Data on resource use
Other measures to allow for the exchange of data among PAC* and other providers to facilitate coordinated care and improved outcomes
Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014

3. CMS Required to Make Interoperable:
IMPACT Act of 2014 (cont.)
CMS Required to Make Interoperable:
Standardized patient assessments
Quality measures data
Data on resource use
Other measures
To allow for the exchange of data among PAC* and other providers to facilitate coordinated care and improved outcomes
Requires the submission of standardized assessment data by:
Long-Term Care Hospitals (LTCHs): LCDS
Skilled Nursing Facilities (SNFs): MDS
Home Health Agencies (HHAs): OASIS
Inpatient Rehabilitation Facilities (IRFs): IRF-PAI
Requires that CMS make interoperable:
Standardized patient assessments
Quality measures data
Data on resource use
Other measures to allow for the exchange of data among PAC* and other providers to facilitate coordinated care and improved outcomes
*Post-Acute Care (PAC)
Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014

4. Hospital to another setting
IMPACT Act Quality Measure: Transfer of Health Information and Care Preferences
Transition:
Hospital to another setting
Individual
Family Caregivers
Service
Providers
Individual’s health information and care preferences
Transition:
PAC to another setting
The IMPACT Act requires a quality measure on the transfer of individual health information and care preferences of an individual to the individual, family care caregivers, and service providers when the individual transitions from:
Hospital or critical access hospital (CAH) to another setting including PAC provider or home
PAC provider to another setting, including a different PAC provider, a hospital or CAH, or home

5. IMPACT Act: Standardized Patient Assessment Data
Functional status
Cognitive function and mental status
Special services, treatments, and interventions
Medical conditions and comorbidities
Impairments
Other categories
PAC providers report standardized assessment data
IMPACT Act requires PAC providers report standardized assessment data in the following categories:
Functional status
Cognitive function and mental status
Special services, treatments, and interventions
Medical conditions and co-morbidities
Impairments
Other categories
Standardized Assessment
Data Reporting Dates
LTCHs, IRFs, SNFs
HHAs*
10/1/18
1/1/19
*HHA=Home Health Agency

6. IMPACT Act: Standardized PAC Patient Assessment Data for Quality Measures
PAC providers required to report standardized assessment data for quality measure domains:
Quality Measure Domains
LTCH
IRF
SNF
HHA
Functional status/cognitive function
10/1/18
10/1/16
1/1/19
Skin integrity
1/1/17
Medication reconciliation
Incidence of major falls
Communicating the existence of and providing for the transfer of health information and care preference
PAC providers required to report standardized assessment data for the following Quality Measure Domains by the following dates:
The measure domains provided in the Act are not exhaustive.

7. Impact Act and Interoperability
Why make PAC assessment data elements interoperable?
“…to allow for the exchange of data among PAC providers and other providers and the use by such providers of such data that has been exchanged, including by using common standards and definitions, in order to provide access to longitudinal information for such providers to facilitate coordinated care and improved Medicare beneficiary outcomes.”
The IMPACT Act requires that CMS make post-acute care assessment data elements interoperable to:
“allow for the exchange of data among PAC providers and other providers and the use by such providers of such data that has been exchanged, including by using common standards and definitions, in order to provide access to longitudinal information for such providers to facilitate coordinated care and improved Medicare beneficiary outcomes.”
Source:

8. Impact Act and Interoperability (cont.)
Why make PAC assessment data elements interoperable?
By sharing data and information that includes common standards and definitions, providers can better coordinate care and improve outcomes for Medicare beneficiaries.
The IMPACT Act requires that CMS make post-acute care assessment data elements interoperable to:
“allow for the exchange of data among PAC providers and other providers and the use by such providers of such data that has been exchanged, including by using common standards and definitions, in order to provide access to longitudinal information for such providers to facilitate coordinated care and improved Medicare beneficiary outcomes.”
Source:

9. IMPACT Act Timeline FY 2017 FY 2018 FY 2019 FY 2022
10/1/16
10/1/17
10/1/18
10/1/21
FY 2017
Standardized resource use measure and some
quality reporting begins.
FY 2018
Confidential feedback provided on previous year’s reports.
FY 2019
Standardized assessment data required. Public quality data available. Penalties take effect for those not reporting.
FY 2022
CMS & MedPAC reports on PAC prospective payment. Study on hospital assessment data.
Source: American Health Care Association (AHCA) and National Center for Assisted Living,
1201 L Street NW Washington, DC 20005,

10. CMS Disclaimer
This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for California, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. CA-11SOW-C