CMS lays out post-acute care data requirements in proposed rule

Agency calls for new measures that assess the transfer of health information to providers and patients.


The Centers for Medicare and Medicaid Services on Wednesday issued a proposed rule for the inpatient rehabilitation facility prospective payment system for Fiscal Year 2020.

Under the rule, CMS is calling for new post-acute care data requirements as well as measures that assess the transfer of health information to providers and patients.

“For the IRF Quality Reporting Program (QRP), we are proposing to adopt two new measures, modify an existing measure and adopt new standardized patient assessment data elements,” states the agency’s proposed rule. “We also propose to expand data collection to all patients, regardless of payer, as well as proposing updates related to the system used for the submission of data and related regulation text.”

CMS is proposing to adopt two new measures: Transfer of Health Information to the Provider–Post-Acute Care, and Transfer of Health Information to the Patient–Post-Acute Care.

According to the rule, the proposed Transfer of Health Information to the Provider–Post-Acute Care (PAC) Measure assesses whether or not a current reconciled medication list is given to the subsequent provider when a patient is discharged or transferred from his or her current PAC setting.

The Transfer of Health Information to the Patient–Post-Acute Care (PAC) measure assesses whether or not a current reconciled medication list was provided to the patient, family or caregiver when the patient was discharged from a PAC setting to a private home or apartment, a board and care home, assisted living, a group home, transitional living or home under care of an organized home health service organization or a hospice.

“Both of these proposed measures support our Meaningful Measures priority of promoting effective communication and coordination of care, specifically the Meaningful Measure area of the transfer of health information and interoperability,” states the rule. “The communication of health information, such as a reconciled medication list, is critical to ensuring safe and effective patient transitions from healthcare settings to home and/or other community settings.”

In addition, the agency is proposing to adopt 22 standardized patient assessment data elements, as well as seven more data elements related to social determinants of health relating to race, ethnicity, preferred language, interpreter services, health literacy, transportation and social isolation.

According to CMS, the standardized patient assessment data elements “will enable or support: clinical decision-making and early clinical intervention; person-centered, high quality care through: facilitating better care continuity and coordination; better data exchange and interoperability between settings; and longitudinal outcome analysis.”

To further interoperability in post-acute care, the proposed rule notes that CMS developed a Data Element Library (DEL) to serve as a publicly available centralized, authoritative resource for standardized data elements and their associated mappings to health IT standards.

Also See: CMS develops data element library for post-acute care

“The DEL furthers CMS’ goal of data standardization and interoperability, which is also a goal of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act),” contends the agency. “These interoperable data elements can reduce provider burden by allowing the use and exchange of healthcare data, support provider exchange of electronic health information for care coordination, person-centered care, and support real-time, data driven, clinical decision making.”

CMS is accepting public comments on the proposed rule until June 17.

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