FAH Hospital Policy Blog

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Rehabilitation | FAH Policy Blog Team

New Podcast: Better Data, Better Outcomes: New Data is Changing Care at Inpatient Rehab Facilities

A discussion with Encompass President and CEO Mark Tarr

The COVID-19 pandemic pushed our nation’s health system to the brink, testing it in ways that once seemed unthinkable, but cooperation, communication, and innovation across the care continuum saved lives – and likely changed the way patients are treated forever.

Inpatient Rehabilitation Facilities (IRFs), like those operated by Encompass Health, stepped up during the pandemic by partnering with acute care hospitals to help patients recover from the virus. It once again showed the critical role of IRFs in making sure patients received the right care in the right setting.

“I’m very proud of the way our organization responded to the needs of the health care community. Early on in the stages of COVID, we determined with the help of our physicians and hospital-based clinical staff that we can not only treat COVID patients, but we could do a really good job in terms of the quality of outcomes. We never turned down a COVID patient, either in our hospitals or our home health agencies. We’re very proud to have treated almost 12,000 COVID patients to date,” Encompass Health President and CEO Mark Tarr recently told Chip during an episode of Hospitals in Focus. “We feel like we played a very vital role and continue to play a vital role in terms of post-acute being a very site-appropriate discharge placement for COVID patients.”

As the COVID surge starts to ease across the country and things slowly return to normal, Tarr says his company is continuing to focus on using data and artificial intelligence to improve care for the patients they serve.

“Our database of over 80,000 inpatient admissions now is specific towards rehabilitation patients and their needs. So, when we look at the data that we have, and we use it for artificial intelligence or predictive modeling for our patients to their benefit,” Tarr said.

This allows caregivers at Encompass facilities to assess the likelihood that a patient may have a setback that could send them back to an acute care hospital. The company is also piloting a fall risk indicator program that can help predict if someone might be at risk of injury once they are discharged.

Tarr and Kahn also discussed the importance of the data requirements included in the IMPACT Act, which passed in 2014.

“I think certainly Encompass Health – and the industry as a whole – feels a responsibility to make sure that we’re using the most appropriate data and most effective data so that the end result of the PAC PPS (unified post-acute care prospective payment system) will be a good model that will be in the best interest for the patients and ultimately in the best interest for CMS as well. But to do that, we think it’s very important to have data that is timely, and currently, the data that they’re using is from 2017 through 2019. It doesn’t really accurately reflect the changes that have gone on in the industry around the various settings, whether that is IRFs or SNFs (skilled nursing facilities) or home health, as well as the patient mix. We’ve seen a change in our patient mix during that timeframe. So, to go back to 2017, ’18, or ’19, you’d be using stale data that is not really representative of where the providers and the IRF space are right now in other post-acute settings. We want to make sure that CMS uses the most up-to-date, relevant data that would apply to the patients and reflect the types of care that is being provided now in the post-acute settings,” said Tarr.

Tarr also addressed the development of a new CMS program integrity demonstration that would require either 100% pre-claim review or 100% post-payment review for all IRF patients to “prevent and identify potential fraud” for all facilities in Alabama, Pennsylvania, Texas, and California. The concern is that it could put up unnecessary barriers to care by having a third-party reviewer overrule rehabilitation trained physicians and deny needed care for patients.