This course examines the current state of rehabilitation outcomes measurement in post-acute care (PAC) settings: inpatient rehabilitation, skilled nursing facility, long term acute care and home health care. Patients cared for in these settings often transition between multiple sites of care when their health and functional status changes, and therefore are particularly vulnerable and costly to the health care system. Currently, performance measurements across PAC settings are fragmented due to the heterogeneity of patient populations, as well as the various reporting mechanisms across settings. This course provides participants with a context for understanding the complex issues that contribute to the questions raised by external agencies and policymakers who seek to understand the value of rehabilitation in post-acute care. Instructor Ellen Strunk describes the efforts currently underway to gather more information and develop meaningful outcome measures to support the value of rehabilitation services in disease management as well as future models of payment.
Ellen R. Strunk, PT, MS, GCS, CEEAA, CHC has worked in various roles and settings as both a clinician and manager/director: hospital, transitional care, Director of Rehab for a hospital home health agency, Clinical Consultant, Director of a HH staffing division, and Director of Governmental Affairs for a company providing rehab services in long term care, home health and outpatient settings. Presently, Ellen is the owner of Rehab Resources & Consulting, Inc., a company providing continuing education and consulting services for post-acute care settings. For the past seven years, she has specialized in helping clients understand and navigate the CMS regulations for post-acute care settings, as well as how to prepare for the transition to a value-based system. Ellen is passionate about delivering medically necessary therapy services in these settings, and lectures nationally on the topics of pharmacology for rehabilitation professionals, exercise and wellness for older adults, the importance of functional outcomes, and coding/billing/documentation for therapy services. Ellen is a member of the American Physical Therapy Association, where she has served on a Payment Policy Strategy Committee advising the APTA Board of Directors on payment policy in all settings. She is a member of the APTA Section on Geriatrics, the APTA Home Health Section and the APTA Health Policy & Administration Sections. She serves on a state level as the President of the Alabama Physical Therapy Association and as its Practice & Reimbursement Chair. She is a member of the American Health Care Association, where over the last three years she has been a part of a therapy workgroup to develop a national quality measure for rehabilitation.
Medicare is going through challenges right now, where the population is aging and the amount of money spent on Medicare beneficiaries continues to climb. This chapter provides a comprehensive overview of the present healthcare environment, including the state of chronic illness in the aging population and the scope of healthcare integrity issues.
How do we define post-acute care (PAC)? PAC is generally defined as these four settings: Skilled Nursing Facilities, Inpatient Rehab Facilities, Home Health, and Long Term Acute Care. This chapter focuses on what these settings currently do to measure quality.
In Home Health, there has also been a shift in case mix weight, meaning that those who receive Home Health are also receiving therapy services. This chapter discusses the impacts of that shift, as well an overview of Medicare Part B services.
After examining in the previous chapter what we have today in terms of quality measures, Ellen Strunk explains why these measures are not enough.
Chapter Five asks the question, “What do we need?” Ellen Strunk explains what we need, moving forward, from a rehabilitation standpoint in order to show the value of the therapist’s services.
So where do we go from here? This chapter examines how we need to think about and use all of the information covered in this course.
Throughout the course, Ellen Strunk has discussed the urgency of why outcomes are important, and how to develop and collect those outcomes. This chapter examines the analytics of those outcomes and what value they can bring to your patient practice.