So ﻿this is day 3 of the training.
It's kind of a little intro, but you guys were here yesterday.
So it's not really an introduction, but we'll still go over and give you a high-level overview
of the IRF Quality Reporting Program.
Oh.
There we go.
The acronyms you guys know CMS, the government in general is famous for acronyms.
We do give you a list of the most frequently used acronyms.
These are all included in this presentation.
So that's pretty self-explanatory.
Our objectives for today's training include an overview of the IRF Quality Reporting Program.
I know most of you are probably very familiar with it.
You live with it every day.
We'll also be summarizing some of the changes to the IRF-PAI that will be effective October
1, 2018.
A little background.
The Inpatient Rehabilitation Facility Quality Reporting Program was established by the Affordable
Care Act in 2010.
Beginning with 2000 fiscal year 2014 a IRF that did not submit their required
quality data is potentially subject to a 2% reduction in their annual increase factor,
we also refer to as your Annual Payment Update.
The IMPACT Act of 2014 further extended the requirements to the inclusion of standardized
data by most of the post-acute care programs.
As you all are aware, we receive quality data for the IRF Quality Reporting Program via
three methods, the IRF-PAI instrument itself, the CDC, via NHSN submissions.
Then we use Medicare claims for some of the measures.
Last year, in last year's rules we actually put out a request for information.
And we solicited feedback from the providers.
We took that feedback, looked at all the information and we have been working on a Meaningful Measures
Framework.
This diagram shows some of the domains and the initiatives that we are attempting to
acknowledge.
There is a link on this slide that if you go to the link, there's a lot of information
about the comments we received, our plans for using this framework as we looked at our
current list of measures and how we evaluate where we're going to move forward.
If there's room for removal?
Where are gaps?
I'm not going to go into all the detail in this, but we've also detailed this in our
Rule this year.
Again the link will be helpful.
It provides helpful information for you.
And also, looking at the Meaningful Measures Framework, we this year in this year's rule
I'm sure you all are aware, we have proposed the removal of two measures in looking at
the data, the validity of the data, is it providing useful information to the consumers?
So we did propose removal of two measures.
The next few slides provide just a list of the 18 measures that are currently existing
in the IRF QRP.
These slides also show the date that you started submitting the data, then also the date that
we're going to begin publicly reporting the data.
This slide includes the Pressure Ulcer measure, because you all are still submitting data
for that.
But it will be replaced by the new Skin Integrity measure, which you guys received training
on yesterday.
And this year's rule we also are proposing that public display of the four functional
outcome measures.
So we expect they will be on Compare this fall.
Again, the measures, this does reflect DRR.
We have the CDC measures.
And I'm sure that you all are aware we have proposed the removal of the MRSA measure.
And then we have the Claims-Based measures.
This includes currently displays the All-Cause Unplanned Readmission measure, but that measure
will be going away in October of 2018.
So the QRP training that you guys are here attending today, the purpose of this training
is to provide the guidance you all need to meet the requirements for the Quality Reporting
Program.
And also the training will include those items that are not necessarily used for purposes
of compliance, but it also includes the risk adjusters that are used to help calculate
the quality measures.
Also during the We Want the Hear From You session yesterday, we do as we said, want
your feedback.
A lot of the changes to the items that we're presenting today are a result of the feedback
we've heard from you.
The helpdesk questions, comments in the rules, like we said the request for information,
so please keep the feedback coming.
We do want to hear from you.
We don't necessarily move very quickly, but we do listen and we are trying, okay.
Again, the IRF-PAI v2.0 becomes effective for patients discharged on or after October
2018.
We also have some links to some of the resources that are available on our page.
The one thing we do want to point out, we know that we have the IRF-PAI, IRF-PAI QRP
Manual tab.
We are aware that we don't have a separate manual for the QRP program.
It is embedded within the training manual for the entire IRF-PAI.
But it is the Quality Indicators section.
We kind of call it the QRP, but it's the QRP Manual, but it's the quality indicators section
of the IRF-PAI manual.
And we also have a Change Table that provides the details that shows the changes from v1.5
to v2.0.
Do you guys use the web pages?
Can I get a show of hands?
Do you all visit our websites on a pretty regular basis?
Great.
This is a diagram that shows some of the changes by section.
As you guys know, yesterday we did present on Section N which is a new section for the
IRF-PAI.
There are also changes to sections B, C, GG and M. And we will cover that today.
We'll also do just a little review of the other sections that remain unchanged.
Some of the items -- this is a high level overview of some of the changes that have
occurred.
We've added the non-verbal content to further clarify assessing the BB0800.
Section C changes include changes to the instructions that allow for use of cues to assist the patient
during your assessment.
Section GG, we added some clarifications, a couple of items including the use of code
10, and incomplete stay skip patterns for discharge self-care and mobility items.
We've also added a skip pattern to the walking and stairs items for activities that did not
occur.
We are trying to consider, you know, the burden that's associated with responding to questions
that may not apply to your patient.
We've also added the use of contact-guard and added definitions for Code 09 in Section
GG.
Section M, we -- as you found out yesterday or learned yesterday we've added the term
"injuries" to the pressure ulcer measure item labels to reflect more accurately the etiology
of what's going on in the description of the pressure ulcers.
We have removed the term "suspected" from the deep tissue injury items.
We have added the term "device" when we're looking at your inability to assess pressure
ulcers.
And we've removed the M0800 items from the discharge assessment.
Section N we did cover yesterday as well.
There are three new items that have been added, two to admission and one to the discharge.
And these items are used to calculate the Drug Regimen Review measure.
There are no changes to these sections up here, but I do want to share, I'm sure you
probably know that we have proposed the removal of the patient flu items.
And we have provided instructions on how you will code for that.
Because if finalized, those changes will be in effect October 1, 2018.
Again, the summary changes by section, the new section which is Section N. You see those
that have changed, then the unchanged sections.
Again more detail on some of the changes by item.
Any questions?
You can also submit your questions via the slido app.
We will be covering some of those today as well.