Rehab facilities facing new quality reporting requirements

Inpatient rehabilitation facilities (IRFs) that fail to report selected quality data could see their Medicare payments reduced by at least 2 percent beginning in fiscal 2014 under a new proposed rule released by the Centers for Medicare and Medicaid Services (CMS) on Friday.

This proposed quality reporting system follows the goals of Partnership for Patients, a new public-private partnership announced by CMS earlier this month that focuses on hospital quality, safety and cost issues.

With the CMS proposed measure, IRFs would submit data on two quality measures--urinary catheter-associated urinary tract infection and pressure ulcers that are new or have worsened--which represent two of the nine conditions identified by the partnership as key areas to reduce harm to patients. A third measure addressing hospital readmissions within 30 days currently is under discussion.

The proposed CMS rule calls for updating the Medicare prospective payment rate to IRFs by 1.5 percent in fiscal 2012--an estimated $120 million nationwide. The new update reflects a revised market basket specific to IRFs, inpatient psychiatric facilities, and long-term care hospitals--minus a 1.3 percent reduction required by the Affordable Care Act.

The proposed rule would take effect at more than 1,200 Medicare-participating IRFs--including 200 freestanding IRFs and about 1,000 IRF units in acute-care and critical-access hospitals.

CMS plans to establish a process for making the data measures available to the public. IRFs choosing to report quality data would have an opportunity to review the data for accuracy prior to becoming public, CMS said. 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.

For more information:
- see the CMS release
- view the Federal Register notice (.pdf)