skip to Main Content

The Great Expanding Quality Reporting Program

Written by: Dennis Stevenson Jr., MBA on Monday, February 15, 2016 Posted in: Inpatient Rehab

In 2012, Medicare introduced the Quality Reporting Program (QRP) to the IRF-PAI reporting process. Prior to this point, IRFUs enjoyed a stable decade of reporting patient outcomes (2001-2011). However, since the introduction of the QRP, IRF-PAI reporting has been all about change. Every year, CMS has adjusted, enhanced or added to the quality reporting data that IRFs must submit.

The early versions of the QRP were quite simple by comparison to the instrument that IRFs must use today. The initial pressure ulcer reporting involved only 11 data elements. Spring forward to 2016 and a look at the IRF-PAI 2017, in which the pressure ulcer section has ballooned to 26 data elements that must be reported. That represents a 136% increase in just 5 years.

Pressure ulcer reporting is just the tip of the iceberg when it comes to the 2017 IRF-PAI. Many IRF leaders know that the upcoming change make the IRF-PAI bigger, but these leaders lack a real context of how much bigger it will be and what that will mean to staff productivity and operations. This lack of knowledge leads to a wait-and-see attitude toward the changes, which may doom their organizations to a crazy fire drill this fall.

To give a sense of the changes, the new IRF-PAI adds approximately 120 data elements per patient to the quality reporting program. These elements are spread across 9 new sections, representing new types of data that must be collected and reported. If you stop and think about it, this means these new elements need to be observed, documented, extracted and assembled—then submitted. If your organization submits data manually to your outcomes vendor, that’s 120 new chances for typographical and other errors.

If you haven’t stopped to consider how much new data will be required in October, today would be a good day to start.