Congressional approval of H.R. 4994, the IMPACT Act in October 2014, mandates the development and implementation of a standardized post-acute care assessment tool, and paves the way for effective payment reforms for Post-Acute Providers.

“Historically paid under separate reimbursement systems, the Impact Act’s goal will have post-acute providers paid under one prospective payment system.”

According to the IMPACT Act, Post-Acute Care (PAC) providers include home health agencies (12,311), skilled nursing facilities (15,000), inpatient rehabilitation facilities (1,166) and long-term acute care hospitals (420). The majority of these providers are for-profit. The legislation excludes assisted living and similar residential care communities (22,200) and adult day service centers (4,800). The supply of nursing home and residential care beds varies by region.

One Prospective Payment System for PAC Providers

Historically paid under separate reimbursement systems, the Impact Act’s goal will have post-acute providers paid under one prospective payment system.

PAC payment reform:
• Payments based on patient needs, not site of care
• Better alignment of payments with care costs
• Payments will shift from some types of cases, providers, and settings to others
• Providers may change how and where PAC services are furnished.


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