CMS Proposes Payment and Policy Changes for Inpatient Rehabilitation Facilities

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for inpatient rehabilitation facilities (IRFs) in fiscal year 2012. The rule proposes to increase payment rates under the IRF Prospective Payment System by a projected 1.5% — an estimated $120 million nationwide. The projected update is specific for IRFs, inpatient psychiatric facilities and long-term care hospitals.

The proposed rule, which would apply to more than 1,200 Medicare-participating IRFs, including approximately 200 freestanding IRFs and approximately 1,000 IRF units in acute care hospitals and critical access hospitals, seeks to establish a new quality reporting system authorized by the Affordable Care Act.

“The proposed rule would extend Medicare’s ongoing efforts to use its payments to encourage better care for beneficiaries who are treated in inpatient rehabilitation facilities,” Donald Berwick, MD, CMS administrator, stated in a press release. “The measures IRFs would report under the proposed rule will pave the way for Medicare to work with IRFs to improve patient safety, prevent patients from picking up new illnesses during a hospitalization and provide well-coordinated person-and-family-centered care.”

The proposed quality reporting system is aligned with the goals of the Partnership for Patients, a new public-private partnership that will help improve the quality, safety and affordability of health care for all Americans. Initially, IRFs would submit data on two quality measures, “urinary catheter-associated urinary tract infection” and “pressure ulcers that are new or have worsened.” These proposed measures represent two of the nine conditions the Partnership has identified as important places to begin in efforts to reduce harms to patients.

“IRFs need to be at the forefront of the quality movement because they play such a critical role in patient care,” Berwick stated in the release. “They are called on to meet the needs of some of our most vulnerable patients and they are responsible for making sure each one of them meets their rehabilitation goals and makes real progress towards improved functional independence.”

CMS will accept comments on the proposed rule until June 21 and will address all comments in a final rule to be issued by Aug. 1.

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