CMS Announces the Start of Participant Recruitment for Post Acute Payment Reform Demonstration
Department of Health & Human Services
Centers for Medicare & Medicaid Services
Room 303-D 200 Independence Avenue, SW Washington, DC 20201
Public Affairs Office MEDICARE NEWS For Immediate release
Contact: CMS Office of Media Affairs
August 20, 2007
The Centers for Medicare & Medicaid Services (CMS) announced the start of participant recruitment for the Post Acute Care Payment Reform Demonstration (PAC-PRD). Participating providers include acute care hospitals and four post-acute care (PAC) settings -- Long Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), Skilled Nursing Facilities (SNFs), and Home Health Agencies (HHAs). A key goal of this project is to generate recommendations for improving CMS payment models based on data collected in the demonstration.
The goals of payment reform include aligning incentives among the four PAC settings with a particular focus on patient populations seen in more than one PAC setting. Other analyses to be explored include the examination of discharge patterns and the comparison of outcomes between settings. An important part of PAC-PRD is improving CMS's ability to understand and compare the populations served in acute hospitals and each of the four PAC settings and the care that is received. Work has been underway for the past year to develop a uniform patient assessment tool for use at discharge from acute hospitals and at admit and discharge from PAC settings.
This patient assessment tool is known as CARE: Continuity Assessment Record and Evaluation. In addition to the CARE instrument, the demonstration has developed methods for measuring the costs and resource use associated with individual patients. The next step will be to implement the demonstration by collecting information from participating providers. At this point, CMS is attempting to recruit providers to participate in this data collection effort. Participation is voluntary. CMS does not envision exercising any waivers of payment rules for this project. CMS will attempt to recruit a sample that is representative of the range of post-acute service providers across the country.
CMS will collect data in ten distinct parts of the country. The choice of which ten markets to select will be influenced by a variety of factors, including population density, geographic area, the presence of different types of PAC providers, and whether there are volunteer providers available. The selection of which providers to include in a given market will depend on characteristics such as patterns of corporate ownership, profit status and size of individual providers, the ability to recruit other providers in the same referral network, and the need to recruit a representative sample. This demonstration is an important and exciting CMS initiative. It will give CMS and Medicare-participating providers better information on the case-mix severity of Medicare beneficiaries using their services. The information will be critical in creating recommendations for refining CMS approaches to measuring case mix intensity in PAC populations. Adopting techniques that provide greater uniformity in how patients are assessed and quality is measured will allow CMS to improve PAC payments.
The Post Acute Care Payment Reform Demonstration was mandated by Congress in the Deficit Reduction Act of 2005. Recommendations generated by the demonstration will be included in as report to Congress that also is mandated as part of the same law. Providers may express interest in participating. In addition, providers may also be targeted for recruitment from analysis of Medicare administrative files and will be contacted. Final selection of the provider participants will occur in the fall of 2007.
Providers interested in potentially participating in the 2008 demonstration should contact Barbara Gage, Ph.D., Principal Investigator at RTI by emailing PAT-COMMENTS@RTI.ORG.