The Next Chapter on the Unified Post-Acute Care Prospective Payment System: Summary of the November 19 CMS/RTI Technical Expect Panel
Kate A. Beller, JD, AMRPA Executive Vice President for Policy Development and Government Relations
Since the passage of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act in 2014, the American Medical Rehabilitation Providers Association (AMRPA) has actively engaged with the entities charged with developing Unified Post-Acute Care Prospective Payment System (UPAC PPS) prototype reports – the Department of Health and Human Services (through the Assistant Secretary for Planning and Evaluation (ASPE) and the Centers for Medicare and Medicaid Services), and the Medicare Payment Advisory Commission (MedPAC). Most recently, AMRPA was well-represented at the November 18, 2019, Technical Expert Panel (TEP) convened by CMS and its’ Unified PAC PPS contractor – the Research Triangle Institute, Inc. (RTI) – which included extensive discussion on the current design elements and overarching policy goals for the CMS/ RTI Unified PAC PPS prototype report. The November TEP was the second of four TEPs currently scheduled by CMS/RTI, with the two remaining TEPs anticipated in early and late 2020, respectively. In contrast to the question-and-answer format used in RTI’s initial TEP in September 2018, RTI outlined a more specific framework and areas of focus for panelist feedback in the November session, found in greater detail below IMPACT Act: Background on Mandated Unified PAC PPS Reports and Recommendations In the five+ years since its passage, policymakers have been charged with carrying out three major mandates under the IMPACT Act: the development of quality measures in specific domains; the development and implementation of standardized patient assessment data elements (SPADE) within the four PAC payment systems; and exploration of a UPAC PPS. For the latter, the Act required a series of reports. The first was a report by the Medicare Payment Advisory Commission (MedPAC) published in June 2016.1 In developing the report, MedPAC utilized the framework from the Post-Acute Care Payment Reform Demonstration (PAC PRD) and its data to evaluate and recommend features of a prospective payment system that establishes payment rates according to patient characteristics rather than PAC setting. Since its initial publication, MedPAC has discussed implementation issues associated with the proposal – such as sequential stays and aligning statutory and regulatory requirements – among others policy issues, with further analysis expected in its 2020 reports to Congress.
1
MedPAC June 2016 Report to Congress
AMRPA Magazine / February 2020 19
