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Medical Rehab

Prepare your team for challenging events through trainings and sessions being offered at the 2023 RCPA Annual Conference A Decade of Unity! Workshops will focus on some difficult topics but will be certain to improve your team’s treatment of patients as well as their own, personal well-being. View the full brochure here, and claim your early bird rate, your hotel, and your discount today so you can gain direct access to workshops such as:

  • Ethics, Suicide, and Coercive Practices: Are We Doing More Harm Than Good?
    • Examine cultural and societal values in relation to suicide, including a discussion on whether physician-assisted suicide is a human right.
  • Reducing Health Disparities Through a Collaborative Approach to Value-Based Contracting
    • Learn about Highmark Wholecare’s intervention into minority adolescent treatment for STIs, which reduced racial/ethnic disparities through Medicaid VBC payment models.
  • Measurement-Based Care: Exploring the Value of a Coordinated Approach in Pennsylvania
    • Analyze the implementation of measurement-based care models across Northeast Pennsylvania through Greenspace Health and Northeast Behavioral Health Care Consortium.
  • Attracting and Retaining the Best Talent: Mitigating Bias in Hiring, From Sourcing Through Onboarding
    • Discover ways in which bias presents itself during the hiring process and how to manage it so that you can find and keep great talent.
  • The Dialectical Behavior Model of Living
    • Study the Dialectical Behavior Model of Living in order to assist neurodivergent individuals in managing their social, emotional, and environmental processes.
  • Debriefing: Supporting Staff and People Supported Through a Traumatic Event
    • Be a leader for your team by utilizing debriefing tactics in order to help your employees when traumatic experiences happen in the workplace.
  • Treating Problematic Sexualized Behaviors Through a Systemic Model
    • Identify warning signs of problematic sexual behavior in adolescents and learn how to approach and treat such behaviors with cultural and ethical considerations.
  • Machine Learning: New Tools to Improve Youth Mental Health Outcomes
    • Hear from Gemma Services on how they improved their PRTF and Outpatient programs through a data analytics firm and the creation of an Insight Generator tool.
  • RCPA Captive Health Plan: NON-CE Offering
    • Learn about the RCPA Captive Health Care program, including benefits, costs, and savings potentials for your organizations.
Register today!

In addition to an impressive roster of speakers, our 2023 Conference will have an exciting array of sponsors and exhibitors. We thank those who have signed on thus far! If you are interested in sponsoring or exhibiting, visit here for more details or contact Carol Ferenz, Conference Coordinator, with any questions you may have. Keep up-to-date and register today for #rcpaconf!

Don’t miss your chance to catch the early bird registration rate for the 2023 RCPA Annual Conference A Decade of Unity! Early bird rates end Friday, September 8, 2023. View our registration brochure to see our full schedule, including networking and Connections Hall events, as well as information on booking your hotel room. Complete the brochure and reserve your seat at the early bird discount rate today!

We also wish to extend our thanks to those organizations that have already contributed and shown their support! Sponsor and exhibitor spots are filling up quickly, so complete the sponsor/exhibitor brochure today! As a reminder, sponsors, exhibitors, and advertisers who wish to be listed on the website, the mobile app, and in the conference program must submit all materials by September 8. In order to be considered for booth self-selection, a completed contract with payment must be submitted, and no reservation is considered complete without payment. If questions remain, please contact Carol Ferenz, Conference Coordinator.

RCPA will be hosting our golf outing to support the RCPA PAC on Monday, October 9, 2023, in conjunction with the Annual Conference. Conference attendees, exhibitors, sponsors, and presenters can now register to participate at the Dauphin Highlands Golf Course, 650 S Harrisburg St., Harrisburg, PA 17113. Registration starts at 10:00 am, lunch will be held at 11:00 am, and the shotgun start begins at 12:00 pm.

Not a golfer, but would still like to support the RCPA PAC? For your convenience, you can now make a personal online contribution, which will provide financial support to state legislators or representatives who have demonstrated a strong, consistent, and positive interest in our legislative priorities.

We would like to thank our tournament sponsor Erie County Care Management, Inc. for their support. Sponsorships are still available for this worthwhile cause. We hope you will consider becoming a golf outing sponsor; it is a great way for your organization to receive name recognition and an opportunity to support the RCPA fundraiser.

Many thanks to our beverage & hole sponsors to date:

  • Novak Strategic Advisors
  • Morgan Stanley Wealth Management
  • Warfel Construction
  • Firetree, Ltd.
  • Christopher S. Lucas & Associates
  • Ceisler Media & Issue Advocacy
  • Pinnacle Treatment Centers, Inc.
  • Salisbury Behavioral Health, a division of RHA Health Services

Image by StockSnap from Pixabay

The Centers for Medicare and Medicaid Services (CMS) has released a short, animated explainer video, “Social Determinants of Health Items: Determining When a Proxy Response is Allowed,” for inpatient rehabilitation facilities (IRF), home health (HH), and long-term care hospital (LTCH) providers. CMS developed this video to assist providers in accurately determining when the use of a proxy response is allowed for the following Social Determinants of Health (SDoH) items: A1005. Ethnicity, A1010. Race, A1110. Language, A1250. Transportation, B1300. Health Literacy, and D0700. Social Isolation.

If you have questions about accessing the resources or feedback regarding the trainings, please email the PAC Training Inbox. Content-related questions should be submitted to the HH QRP Help Desk, IRF QRP Help Desk, or the LTCH QRP Help Desk.

The Medicare Payment Advisory Commission (MedPAC) has published the 2023 Data Book Health Care Spending and the Medicare Program, which provides information on national health care and Medicare spending as well as Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care in the Medicare program, and Medicare beneficiary and other payer liability. It also examines provider settings — such as hospitals and post-acute care — and presents data on Medicare spending and beneficiaries’ access to care in the setting (measured by the number of beneficiaries using the service, number of providers, volume of services, length of stay, or through direct surveys). Specifically of interest is information on dual-eligible beneficiaries, including individuals with disabilities, and information on alternative payment models.

Summer is flying by, and so, too, is the opportunity for early bird registration rates for the 2023 RCPA Annual Conference A Decade of Unity! Early bird rates end Friday, September 8, so be sure to register today and claim your seat, your hotel room, and your discount! View the full brochure for details as well as information on our roster of workshops, keynote speakers, and plenary sessions. You’ll be able to earn CEs from workshops such as:

  • Getting Past the First Meeting to the Contract Negotiation
    • Learn how to present a solution in health and human services to health plan payors based on what the payor needs and looks for.
  • Bridging Generational Differences in the Workplace
    • Explore the generational diversity in your workforce and how to leverage each generation’s strengths to your competitive advantage.
  • Transforming Organizational Wellness and Self-Advocacy Through an Evidenced-Based Practice: Improving the Lives of Employees and Individuals in Our Care
    • Identify the benefits of and methods for implementing a wellness program to improve employee wellness and support consumers and families served in MH/IDA.
  • Revealing the Potential of Smart Home Technologies for People With Disabilities Through Research and Resources
    • Examine smart home technologies, their uses for people with disabilities, and the expanding field of research and resources for the tech.
  • Our HAIR (Health Access Initiative for Recovery): Making a Difference With Health Equity
    • Listen to an in-depth overview of Community Care’s “Our HAIR” program, which was developed as a targeted intervention to address racial disparities in access to behavioral health care.
  • Implementing and Sustaining Evidence-Based Practices
    • Develop evidence-based practices for childhood trauma via CenClear’s Healing After Trauma program.
  • Selective Contracting or Managed Care: Either One Will Change Your World
    • Learn about the impact selective contracting and managed long-term services & supports will have on the IDD community.
  • Findings on Stakeholder Engagement for the PA Master Plan for Older Adults
    • Discuss what the Master Plan is intended to accomplish and learn of preliminary findings from the stakeholder engagement process.
Register today!

In addition to an impressive roster of speakers, our 2023 Conference will have an exciting array of sponsors and exhibitors. We thank those who have signed on thus far! If you are interested in sponsoring or exhibiting, visit here for more details or contact Carol Ferenz, Conference Coordinator, with any questions you may have. Keep up-to-date and register today for #rcpaconf!

The Pennsylvania Office of Medical Assistance Programs (OMAP) Pediatric Shift Care Team is conducting a survey to identify individuals interested in participating in the development of education and training content for a new online learning portal. More will be shared about this effort during the upcoming Stakeholder Update Call, which is taking place on August 15 from 10:30 am – 12:00 pm.

If you are interested in participating in the initiative, please take this short 2-minute survey: Pediatric Shift Care Subject Matter Expert Interest Survey. The survey has been extended and will close on August 18, 2023, following the Stakeholder Update Call.

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The Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2024 inpatient rehabilitation facility (IRF) prospective payment system (PPS) final rule in the August 2, 2023, Federal Register. Some of the key provisions contained in the final rule include:

Payment and Coverage Provisions

  • FY 2024 Market Basket Update and Productivity Adjustment: For the FY 2024 IRF PPS payment adjustments, CMS estimates that ‎IRFs will see a 4.0 percent increase in total payments (totaling an increase of $355 million) ‎relative to FY 2023. This update is a result of a 3.6 percent market basket update, minus a ‎‎0.2 percent productivity adjustment.
  • 2021-Based IRF Market Basket: The final rule rebases and revises the IRF market ‎basket to reflect a 2021 base year (which reflects more recent data). ‎Moving forward, CMS says that it will “continue to monitor the Medicare cost report ‎data as they become available” and consider updates to the IRF market basket in future ‎rulemaking.‎
  • Case Mix Groups: Consistent with the proposed rule, CMS estimates that the vast ‎majority of cases will be in case mix groups (CMGs) and tiers that will see a ‎change of less than 5 percent in FY 2024. ‎
  • Outlier Threshold: CMS is finalizing the outlier threshold amount of $10,423, which is estimated to be ‎approximately 3 percent of the total estimated aggregate IRF payments in 2024. CMS also ‎notes that finalized changes in the Average Length of Stay (ALOS) values for FY 2024, ‎compared with FY 2023 ALOS values, are small and do not show any particular trends ‎in IRF length of stay patterns.
  • Wage Adjustments and Labor-Related Share: CMS finalized proposals to update the ‎wage index adjustments using the same methodology and factors as previous updates. ‎Based on forecasts, the total labor-related share for FY ‎‎2024 is 74.1 percent (the sum of 70.3 percent for operating costs and 3.8 percent for the labor-related share ‎of Capital-Related costs).
  • Impact Estimate: Overall, the estimated payments per discharge for IRFs in FY 2024 ‎are projected to increase by 4.0 percent, compared with the estimated payments in FY 2023. ‎IRF payments per discharge are estimated to increase by 4.0 percent in urban areas and 3.6 percent ‎in rural areas, compared with estimated FY 2023 payments. Payments per discharge to ‎rehabilitation units are estimated to increase 4.5 percent in urban areas and 3.9 percent in rural ‎areas. Payments per discharge to freestanding rehabilitation hospitals are estimated to ‎increase 3.7 percent in urban areas and 2.8 percent in rural areas.‎
  • Modifications for Excluded IRF Units: Consistent with the proposed rule, CMS is ‎finalizing new flexibilities for rehabilitation units that are seeking to be excluded from ‎the acute inpatient PPS and paid under the IRF PPS for the first time. Hospitals will now ‎be allowed to open a new IRF unit (and get paid as such) at any time within the cost ‎reporting year, instead of being limited to only the beginning of a cost reporting period. ‎The hospital must notify the CMS Regional Office and Medicare Administrative ‎Contractor (MAC) in writing at least 30 days before the change. If a unit becomes ‎excluded during a cost reporting year, that change must remain in effect at least through ‎the rest of that cost reporting period. ‎

Quality Reporting Program (QRP) Provisions: ‎CMS finalized all of the proposed changes related to quality measures for the IRF QRP put forth in the proposed ‎rule. The following changes have been finalized for the IRF QRP:

  • Implementation of the New COVID-19 Vaccine for Patients: Data collection for the ‎‎“Percent of Patients/Residents Who Are Up-to-Date” will be placed on an updated IRF-‎Patient Assessment Instrument (PAI) and begin with discharges on or after October 1, 2024, for use in the FY 2026 IRF ‎QRP.‎
  • Update of the COVID-19 Vaccination Measure for Healthcare Personnel: CMS ‎finalized its proposed modification of the COVID-19 Vaccination Coverage among‎ ‎Healthcare Personnel (HCP COVID-19 Vaccine) measure‎ to include the CDC “up-to-‎date” consideration for reporting purposes. Data collection for this modification is to ‎begin October 1, 2023, for use in the FY 2025 IRF QRP.‎
  • Implementation of the New Discharge Function Score Measure: No new data ‎collection is required, but the calculations and reporting of this measure will begin with ‎discharges on or after October 1, 2023, for use in the FY 2025 IRF QRP.‎
  • Measure Removal: Three measures have been removed from the IRF QRP and will no ‎longer require the collection of certain data elements for discharges on or after October ‎‎1, 2023:‎
    • Application of Percent of Long-Term Care Hospital Patients with an Admission ‎and Discharge Functional Assessment and a Care Plan That Addresses Function;
    • IRF Functional Outcome Measure: Change in Self-Care Score for Medical ‎Rehabilitation Patients (CBE #2633)‎; and
    • IRF Functional Outcome Measure: Change in Mobility Score for Medical ‎Rehabilitation Patients (CBE #2634)‎.
  • New Public Reporting: CMS announced the start of public reporting for the following ‎measures:‎
    • Transfer of Health (TOH) Information to the Provider — Post-Acute Care (PAC) ‎Measure (TOH-Provider) beginning with September 2025 Care Compare refresh ‎‎(even though proposed rule and other language in final rule stated September ‎‎2024 Care Compare refresh)‎. CMS staff has been alerted to this discrepancy.
    • TOH Information to the Patient — PAC Measure (TOH-Patient) beginning with ‎September 2025 Care Compare refresh (even though proposed rule and other ‎language in final rule stated September 2024 Care Compare refresh)‎.
    • Discharge Function Score Measure — Beginning with the September 2024 Care ‎Compare refresh or as soon as technically feasible.‎
    • COVID-19 Vaccine: Percent of Patients/Residents Who Are Up-to-Date Measure — Beginning with the September 2025 Care Compare refresh or as soon as ‎technically feasible.‎

CMS also released a fact sheet on the final rule. The data files associated with the final rule, including the wage index tables, the rate setting data for each IRF, and the ‎final tables for case-mix groups, relative weights, and average lengths of stay are also available. Unless otherwise ‎noted above, the provisions in the final rule will take effect on October 1, 2023. ‎