Post-acute care (PAC) providers play an essential role in new care delivery models, but relief from burdensome regulations is needed so they can continue innovations that bring value to patients, a panel of PAC leaders told congressional staff Jan. 13 at an AHA-sponsored briefing on Capitol Hill. 

Bill Altman, executive vice president for strategy, policy and integrated care at Kindred Healthcare in Louisville, Ky., said it’s imperative to “remove some of the barriers around information sharing, clinical integration and other fee-for-service rules that really inhibit our ability” to move from a disintegrated system to an integrated system.

Justin Hunter, senior vice president of public policy, legislation and regulations at HealthSouth in Birmingham, Ala., said that as PACs move forward in alternative payment models like bundling, accountable care organizations and others, “it is vitally important for policymakers to provide PAC providers with affirmative regulatory relief.”

Leaders from Brooks Rehabilitation Hospital in Jacksonville, Fla., and Burke Rehabilitation Hospital in White Plains, N.Y., also participated in the briefing.


PAC innovation, partnerships with hospitals already underway. Many PAC providers have developed innovative programs and are working with hospitals and other organizations to improve outcomes for patients and lower costs.

“We work very closely with our acute care hospital partners,” said Michael Spigel, president and chief operating officer of Brooks Rehabilitation Hospital. The hospital participates in Medicare’s Bundled Payments for Care Improvement Initiative, and it works with 14 acute-care hospitals and six major health systems on efforts around population health.  

Strategic partnerships with hospitals and other organizations provide opportunities for expanded clinical pathways, said Mary Beth Walsh, M.D., CEO and executive medical director of Burke Rehabilitation Hospital, and an AHA board member. Last year, Burke Rehabilitation Hospital became part of Bronx, N.Y.-based Montefiore Health System, and Walsh believes the alignment will provide more value to patients, including better care coordination, patient navigation and oversight.


Further changes done in concert with IMPACT Act. The panelists discussed many changes that are occurring in the PAC field and cautioned Congress against adding further reforms that are not in concert with Improving Medicare Post-Acute Care Transformation Act, or IMPACT Act.

“The IMPACT Act is fundamental in setting out a framework, schedule and timeline for PAC reform,” said HealthSouth’s Hunter.

Enacted in 2014, the IMPACT Act requires long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities and home health agencies to report standardized patient assessment data and quality and resource use measures. Its reporting requirements would be phased in over time, with initial reporting for some providers beginning Oct. 1, 2016. The legislation also requires the Department of Health and Human Services and Medicare Payment Advisory Commission to report to Congress on recommendations for a PAC payment system based on patient characteristics rather than treatment setting. 

The AHA recently released a TrendWatch report offering guidance to PAC providers and their partners as they evaluate new models of care delivery and payment.

Post Acute Innovations


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