Home Health & Hospice Week

IMPACT Act could pave the way for increased home care usage.

Get ready for a change to your assessment practices under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014.

The law will require consistent, core data elements on each post-acute care setting’s assessment tool — including home health agencies’ OASIS. Eventually the goal is to create an assessment tool for all PAC settings to be used for transfer of care or discharge planning.

While home health agencies may be bracing for assessment disruption, the requirement could have some benefits too. Here are a few reasons why policymakers and providers support this move:

1) Medical decision-making in its rightful place. Picture a patient being discharged from acute care after a stroke-like event. Physician Charles Crecelius, chair of the Society for Post-Acute and Long-Term Care Medicine’s (AMDA) public policy committee, had such a patient recently. “Right now, the local insurance company is deciding whether she needs to be in an LTCH or SNF or if she needs home- and community-based services,” he says. “That really shouldn’t be an insurance company’s decision.”

A standardized tool, however, would give clinicians (in both acute hospital and PAC settings) more solid information to make the best decision of where to place the patient next.

2) Nationwide consistency. Patient placement varies widely from region to region — so are patients truly going where their needs will best be served, or just to the most popular setting in their area? “For example, home-and community-based services are used all the time in the Dakotas, but down in Missouri, they’re hardly ever used,” Crecelius points out.

3) A research goldmine. A universal tool (and core data elements on each setting’s tool) opens a great opportunity to collect consistent patient and outcomes data. With this information, providers can really start to target best practices in placing patients. “If I’m sending someone to an LTCH, why? What services would best meet their needs?” Crecelius says. “Data from other parts of the country could show best practices, so this would be a great research tool, and it’s frankly overdue.”

4) Smoother care transitions. Uniform patient information that can cross settings will lead to more efficient transitions and better care coordination. “There’s a lot of evidence about poor transitions leading to medication errors and a whole host of issues,” says Alex Bardakh, director of public policy for AMDA. And these problems could be mitigated with more coordinated care.