Many IRF Patients Experience Interruptions in Care – About 10% Due to Preventable Conditions

New research into Medicare data has found that potentially costly interruptions in inpatient rehabilitation for neurological conditions may be occurring for as many as 1 in 3 patients, depending on the condition—and about 10% of all interruptions are related to complications that are considered preventable.

In an article e-published ahead of print in The American Journal of Physical Medicine and Rehabilitation, researchers analyzed data from nearly 80,000 Medicare beneficiaries admitted to an inpatient rehabilitation facility (IRF) for services related to stroke (71,769), traumatic brain injury (TBI; 7,109), and spinal cord injury (SCI; 659) between 2012 and 2013. Their analysis was focused on the prevalence and causes of 2 types of interruptions in care: “program interruptions,” wherein patients are transferred to another facility and returned to the IRF within 3 days; and “short-stay transfers,” in which patients are transferred to a hospital, skilled nursing facility (SNF), or other facility before their expected IRF length-of-stay ends.

Full story of IRF patients and interruptions in care at APTA

SNF, IRF Final Rules Increase Payment—And Reporting Requirements

In final rules for 2017, the Centers for Medicare and Medicaid Services (CMS) has followed through on its proposed push for more quality reporting and new payment models for skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs). Those rules, issued last week, also include a 2.4% increase in payments to SNFs, and a 1.9% increase for IRFs.

APTA has created summaries of the rules, available online (for the SNF final rule visit APTA’s Medicare Payment and Policies for Skilled Nursing Facilities pageand look under the “APTA Summaries” header; for the IRF final rule, visit the APTA Medicare Payment and Policies for Hospital Settings page, and scroll down to the “APTA Summaries” section under “Inpatient Rehabilitation”). Here are some of the highlights.

Full story of SNF and IRF final rules increase payment at APTA

CMS Offers Training on Coming IRF Changes

Changes to reporting requirements for inpatient rehabilitation facilities (IRFs) are coming this fall, and the Centers for Medicare and Medicaid Services (CMS) is helping providers prepare.

Now available for free download from CMS: presentation slides from a recent 2-day workshop that explored the ways that reporting on everything from functional abilities to falls will change under rules that implement portions of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. That law, passed in 2014 and supported by APTA, seeks to standardize data collected across postacute health care settings. The new reporting requirements begin October 1, 2016.

Originally presented as a “train-the-trainer” event in mid-May, the meeting’s agenda and all slides can be found by scrolling down the CMS IRF Quality Reporting Training webpage to the Downloads section. The compressed files, all pdf versions of PowerPoint slides, are labelled “IRF Training” 1, 2, and 3. Recordings of the training sessions will be posted to the CMS YouTube site in several weeks.

Full story of training on inpatient rehabilitation facilities changes at APTA

SNF and IRF Proposed Rules Continue CMS Push Toward Quality Reporting, Value-Based Payment

Continued emphases on quality reporting and new payment models are at the center of the Centers for Medicare and Medicaid Services’ (CMS) proposed 2017 rules for skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs), along with an $800 million increase in payments to SNFs, and a $125 million increase for IRFs.

SNFs
CMS is proposing an overall payment increase of 2.1%, or an estimated $800 million, but the rule also includes notice that CMS is continuing its push for quality-reporting measures required by the Improving Post Acute Care Transformation (IMPACT) Act. The 2017 proposed rule adds to the list of quality measures that will be required of SNFs beginning in 2018 to include data on discharge to community, Medicare spending per beneficiary, and potentially preventable 30-day readmissions. The proposal also stipulates that by 2020, SNFs will be required to supply reports on drug regimen reviews with follow-up.

Full story of SNF and IRF proposed rules towards quality reporting at APTA

Inpatient Rehab, Inpatient Payment Final Rules Confirm Push for More Outcome Measures—And Tougher Penalties

Data, data, data. The final rules for inpatient rehabilitation facilities (IRF) payment and the inpatient prospective payment system (IPPS) continue the Centers for Medicare and Medicaid Services’ (CMS) effort to put teeth into its push for more quality reporting while offering a mix of payment increases and cuts.

In rules that aren’t significantly different from what they were when proposed in April (IRF, IPPS), CMS is applying more pressure to make the shift to a system it describes as being “based on the quality, rather than the quantity of care [health care providers] give patients.”

CMS issued fact sheets on both the IRF and IPPS final rules. Here’s a quick rundown.

Full story of inpatient payment final rules at APTA

IMPACT Act Standardizing Postacute Care Data Signed Into Law

Legislation that would standardize data used across postacute care (PAC) settings has been signed into law and will join a larger package of reforms. APTA worked to influence this legislation.

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act signed by President Barack Obama on Monday directs 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).

The House and Senate passed the legislation in September.

Full story of the IMPACT Act at APTA

Postacute Care Data Reform Legislation Passes Both Houses

Legislation that would standardize data used across postacute care (PAC) settings has now passed in both houses of Congress and could soon become part of larger reforms. APTA has been working to influence this legislation.

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act now approved by both the House and Senate 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).

Full story of passing of postacute care bill at APTA