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Discharge to Community-Post Acute Care Measure for Inpatient Rehabilitation Facilities (IRF)

CBE ID
3479
Endorsement Status
1.0 New or Maintenance
1.1 Measure Structure
Previous Endorsement Cycle
Is Under Review
No
Next Maintenance Cycle
Fall 2025
1.6 Measure Description

The Discharge to Community-Post Acute Care Measure for Inpatient Rehabilitation Facilities (DTC-PAC IRF) was developed to address the resource use and other measures domain of Discharge to the Community mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). This outcome measure assesses successful discharge to community from an IRF, with successful discharge to community including no unplanned rehospitalizations and no death in the 31 days following IRF discharge. The measure reports an IRF’s risk-standardized rate of Medicare fee-for-service (FFS) patients who are discharged to the community following an IRF stay, and do not have an unplanned readmission to an acute care hospital or long-term care hospital (LTCH) in the 31 days following discharge to community, and who remain alive during the 31 days following discharge to community. The measure is calculated using two consecutive years of Medicare FFS claims data and was developed using calendar year (CY) 2012-2013 data. This submission is based on fiscal year (FY) 2016-2017 data; i.e., IRF discharges from October 1, 2015 through September 30, 2017.

The measure was adopted by the Centers for Medicare & Medicaid Services (CMS) for the IRF Quality Reporting Program (QRP) finalized in the FY 2017 IRF Prospective Payment System (PPS) Final Rule and implementation began October 1, 2016 [1]. Confidential feedback reports on measure performance were distributed to IRF providers in Fall 2017. The measure will be publicly reported on the IRF Compare website (https://www.medicare.gov/inpatientrehabilitationfacilitycompare/) in Fall 2018 using FY 2016-2017 data. Four claims-based discharge to community measures were developed for IRF, LTCH, skilled nursing facility, and home health agency settings to meet the mandate of the IMPACT Act. These measures were conceptualized uniformly across the four settings, in terms of the definition of the discharge to community outcome, the approach to risk-adjustment, and the measure calculation.

References
[1] Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2017 Federal Register, Vol. 81, No. 151. https://www.gpo.gov/fdsys/pkg/FR-2016-08-05/pdf/2016-18196.pdf

Measure Specs
General Information
1.7 Measure Type
1.3 Electronic Clinical Quality Measure (eCQM)
1.8 Level of Analysis
1.20 Types of Data Sources