Medicare Impact Act

Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). As a result, hospitals have to help patients, their representatives, and families by sharing data on quality measures for home health agencies (HHAs), skilled nursing facilities (SNFs), inpatient rehab facilities (IRFs), or long-term care hospitals (LTCHs) — in a way that’s relevant to patient goals of care and treatment preferences.

The new regulation will also boost interoperability by requiring that patients be able to access their medical records in the format of their choice.

Under the Conditions of Participations (CoPs) changed by the final rule, hospitals and Critical Access Hospitals(CAHs) must engage in an effective discharge planning process that focuses on the patient’s goals and treatment preferences and includes the patient and his or her caregivers as active participants in the process. As part of the planning process, the hospital or CAH must consider all of the Post Acute Care(PAC) settings that may be appropriate for the patient’s continued care, including SNFs, IRFs, LTCHs, HHAs, and non-health care services and community based providers. Upon the patient’s discharge, the hospital or CAH must provide the PAC service or provider that will be responsible for the patient’s continued care with all medical information relating to the patient’s care, including the patient’s discharge plan.

Specific to hospitals, the final rule modifies several requirements pertaining to the list of PAC providers that must accompany the discharge plan of patients that are referred for HHA services, or discharged to SNF, IRF, or LTCH facilities. Now, hospitals must include IRFs and LTCHs on these lists in addition to HHAs and SNFs. Additionally, for patients enrolled in managed care programs, hospitals must educate the patient about the need to verify whether a PAC provider or supplier is a network participant.

HHAs are also required to provide discharge plans to patients and their caregivers, including the quality and resource use measures for SNFs, IRFs, LTCHs, and other HHAs to which the patient may be discharged. Like hospitals and CAHs, HHAs must provide all necessary information to the PAC where the patient’s treatment will continue. Within a newly created CoP for HHAs, though, CMS requires that the HHA provide additional information to the PAC or health care provider rendering ongoing care to the patient.