Testing new assessment data elements to ensure quality and consistency of care across post-acute care settings.

Challenge:

Congress passed the “Improving Medicare Post-Acute Care Transformation Act of 2014” (the IMPACT Act of 2014) that requires Medicare to develop, implement and maintain standardized assessment data elements across skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and long-term care hospitals.  To accomplish this, new questions were developed and are being tested for reliability and validity across all post-acute care settings and in diverse markets across the country.

Solution:

Under a contract with CMS, RAND partnered with Qualidigm and Abt Associates to develop and test these new data elements in all four post-acute care settings.  The evaluation is occurring in three phases and began in 2016:  Alpha 1 was implemented in Boston and Hartford followed by Alpha 2 in Chicago, Denver, and Houston. The Beta phase began in 2017 and runs through summer of 2018 in 14 markets with 29 field nurses, over 150 facilities and over 300 field facility staff participating in the project.

Benefit:

Standardizing data elements across post-acute care settings is expected to support comparable data across the care continuum thereby improving care transitions, quality and consistency of care, and payment reform.