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The IMPACT Act Is a Driving Force Behind the Changes in Home Health

Posted on Friday, January 27, 2017 5:14 PM

The Improving Medicare Post-Acute Care Transformation or IMPACT ACT of 2014 is a key driving force behind the changes home health is experiencing today. The IMPACT ACT requires the submission of standardized data by long-term care hospitals (LTCHs), skilled nursing facilities, (SNFs), home health agencies, (HHA) and inpatient rehab facilities (IRFs).

Along with many other requirements, The IMPACT ACT requires the specific reporting of standardized patient assessment data with regard to quality measures, resource use and other measures to provide information for providers to facilitate coordinated care and improved Medicare beneficiary outcomes.

The newly implemented version of OASIS, OASIS-C2, that went into effect January 1, 2017, includes changes to assist in the standardization of data collection and reporting across post-acute setting for reporting purposes. Additional changes to further support this initiative will occur at some point in the future.

OASIS-C2 includes three new items, revised and renumbered M-items, including changed look-back periods at transfer and discharge and changes in drug regimen review and pressure ulcers. The addition of the “dash” in seven items was also added to include overall formatting changes that include boxes instead of lines and single box entry format. All of these changes start the process of standardization of data collection.

Additionally, the PPS case-mix adjustment model for 2017 had several changes. Currently, there are 153 payment groups derived from OASIS item responses. M1200 vision and M1400 dyspnea remain in the model but no longer add points to the equation. M2020 injectable medications was removed from the model. Along with the above OASIS changes, quality measures are going to be obtained from five domains within OASIS.

The following five domains within OASIS include:
• Functional
• Cognitive
• Skin integrity and changes
• Medication regimen
• Reconciliation, falls and transfer of health information and care preferences when an individual transition

Currently, with the implementation of OASIS-C2, data collection begins with two of the five domains:
• Skin integrity and changes
• Medication regimen and reconciliation

The other three are in current development for future OASIS versions.

The IMPACT ACT is just one aspect of the many changes directed towards standardization and quality measures. The shift in home health payment and quality depends on your clinicians, your agency's understanding of OASIS and the accuracy of your OASIS assessments. You must understand the measures and what those measures mean. Lastly, you must be aware of your improvement strategies so you can impact your measures. Today, quality and payment are one in the same. Make sure your agency is ahead of the game.

Contact Corridor to learn more about our Coding Services and multi-level OASIS reviews and our Education Services for OASIS-C2 on CHEX eLearning and OASIS products. 1-866-263-3795

For more information on OASIS-C2, visit Corridor’s Bookstore here.

 Written by Peggy Patton, RN, MHCL, Corridor's Vice President of Education Services.

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