IMPACT Act

The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires reporting standardized, interoperable patient assessment data on quality, resource use and other metrics.

WHY

The IMPACT Act aims to develop cross-setting quality comparisons including:

Skin integrity and changes in skin integrity (in effect 1/1/2017 for HHAs);
Functional status, cognitive function, and changes in function and cognitive function (in effect 1/1/2019 for HHAs);
Medication reconciliation (in effect 1/1/2017 for HHAs);
Incidence of major falls (in effect 1/1/2019 for HHAs);
Transfer of health information and care preferences when an individual transitions (in effect 1/1/2019 for HHAs);
Resource use measures, including total estimated Medicare spending per beneficiary (in effect 1/1/2017 for HHAs);
Discharge to community (in effect 1/1/2017 for HHAs); and
All-condition risk-adjusted potentially preventable hospital readmissions rates (in effect 1/1/2017 for HHAs).

WHO

The IMPACT Act affects providers in the Post-Acute Care (PAC) space, including Home Health Agencies (HHA), Long-Term Care Hospitals (LTCH), Inpatient Rehabilitation Facilities (IRF) and Skilled Nursing Facilities (SNF). It does not affect hospices.

WHEN

The IMPACT Act will be implemented in several phases. The first phase impacting HHAs begins January 1, 2017. Reports will be available one year after initiation of data collection.

TO DO

Prepare your agency to migrate from OASIS-C1 to OASIS-C2. (As part of this process, you will need to confirm whether your medical record vendor is changing.)
Assess your agency’s current pressure ulcer rate; if necessary make plan to reduce rate.
Assess your agency’s current medication reconciliation process; ensure reliability.
Review your agency’s readmission and discharge rates; assess opportunities for improvement.

RISK

Failure to report measures will result in a 2% reduction in market basket in 2018. Ultimately these quality measures will be used to inform the payment policy for all types of PAC.