Lawmakers propose post-acute care data standards

(LHP) (LHP)

Republicans have worked with Democrats to develop rules post-acute care Medicare providers could use to report on their performance.

The proposal, the "Improving Medicare Post-Acute Care Transformation Act of 2014" bill, would have a direct effect on long-term care (LTC) hospitals, skilled nursing facilities, home health agencies, rehabilitation services, and other facilities and organizations that provide care for Medicare enrollees who are recovering from injuries and acute illnesses.

The bill would require post-acute care providers that accept Medicare to release standardized data on the quantity and quality of the care provided starting in 2017. 

Medicare program managers could use the data to grade the providers as early as 2019, and the managers could begin building the assessment data into a new post-acute care payment system around 2022.

The team that developed the draft included House Ways and Means Committee Chairman Dave Camp, R-Mich.; Rep. Sander Levin, D-Mich., the highest ranking Democrat on the House Ways and Means Committee; Senate Finance Committee Chairman Ron Wyden, D-Ore.; and Sen. Orrin Hatch, R-Utah, the highest ranking Republican on the Senate Finance Committee.

In theory, Medicare does not pay for LTC services, but many of the post-acute care services it covers are similar to or identical to the kinds of services that commercial short-term care insurance (STCI) and long-term care insurance (LTCI) plans cover.

Because Medicare pays for so much health care, any standards it adopts, or thinks about adopting, could affect reporting and quality standards in the commercial major medical insurance, STCI and LTCI markets.

The lawmakers who developed the draft argue in a summary that a lack of standardized post-acute care data keeps providers and policymakers from improving the post-acute care payment system.

The federal Medicare Payment Advisory Commission called for the development of a post-acute care assessment tool back in 2005, the lawmakers say.

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