Partners HealthCare System (PHS) had significant representation in Medicare's recent Post-Acute Care Payment Reform Demonstration project. Nationwide, only 150 providers were selected to participate in the study and PHS had 4 of its hospitals- Brigham and Women's Hospital, North Shore Medical Center, Shaughnessy-Kaplan Rehabilitation Hospital, and Spaulding Rehabilitation Hospital- participating. This was a critical study that will help to shape the future reimbursement system for post-acute care. Recognizing the burden to hospitals involved in data collection, CMS exempted our four hospitals from RAC review during the year-long process.
Data collection began in the spring of 2008. Acute care hospitals utilized the Continuity Assessment Record and Evaluation (CARE) tool to gather information on Medicare patients' medical, functional, cognitive impairments, and social/environmental factors. When discharged to a post acute setting, the receiving facility would also perform a CARE evaluation, followed by additional data collection using the Cost and Resource Utilization (CRU) tool. The CRU focused on time and resources spent by different clinical disciplines with different types of patients, and was completed for Medicare and non-Medicare patients. Data collected was reviewed for quality, and submitted electronically to medicare.
One year later, our participation in the project is in large part finished; however, we expect to remain "at the table" to add to RTI's findings and recommendations to CMS about cost, resource and potential reimbursement impacts to post acute providers
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