DEVELOPMENT AND REFINEMENT OF CANDIDATE ASSESSMENT ITEMS FOR POST-ACUTE CARE CROSS-SETTING STANDARDIZATION

摘要

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 mandated the modification of the patient assessment instruments that the Centers for Medicare & Medicaid Services (CMS) requires be submitted by post-acute care (PAC) providers to enable the reporting of standardized patient assessment data with regard to quality measures and specific clinical, patient assessment categories. The PAC providers include Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs) and Inpatient Rehabilitation Facilities (IRFs). PAC is a common and important stage in the continuum of care for older adults: each year, about 40% of hospitalized Medicare beneficiaries are discharged to PAC settings for additional therapy or treatments. This symposium will present research conducted on behalf of CMS to identify, develop and refine candidate cross-setting assessment items reflecting clinical categories specified in the IMPACT Act. The presentations highlight the iterative development process starting with a thorough environmental scan, which included a literature review, consensus vetting via input from the clinical experts, Technical Expert Panel meetings, pilot testing and additional stakeholder engagement activities, such as public comment periods, culminating in a national Beta test that utilized over 300 field staff at 158 facilities in 14 geographic regions. The first presentation in this symposium provides an overview of the project including general timeline, stakeholder outreach and feasibility testing activities. Each of the remaining three presentations provide detail on the development and refinement of specific sets of items for assessment of: 1) pain, 2) medication reconciliation, and 3) health-related quality of life.