As more and more emphasis is placed on therapy outcomes, two programs have made it to the top of the list for implementation.
1. National Outcomes Measurement System (NOMS) for Speech-Language Pathologists
ASHA’s National Outcomes Measurement System (NOMS) is a voluntary data collection system developed to illustrate the value of speech-language pathology services provided to adults and children with communication and swallowing disorders.
The key to NOMS is the use of ASHA’s Functional Communication Measures (FCMs). FCMs are a series of disorder-specific, seven-point rating scales designed to describe the change in an individual’s functional communication and/or swallowing ability over time. Based on an individual’s treatment plan/IEP, FCMs are chosen and scored by a certified speech-language pathologist on admission and again at discharge from SLP services to depict the amount of change in communication and/or swallowing abilities after speech and language intervention and submitted to ASHA’s national registry. In addition to scoring the FCMs, SLPs also provide basic information on patient/client demographics and intervention characteristics (e.g., SLP diagnosis, frequency/intensity of treatment).
The NOMS FCMs can be used to assist with Medicare’s claims-based reporting. The CMS measures, known as “G-codes” with accompanying severity/complexity modifiers, can easily crosswalk to the NOMS 7-point scales. It is important to note that the FCMs are only one component of NOMS. To receive access to all of the components of NOMS — the national database of treatment outcomes and customized data reports — your organization must subscribe to NOMS and become a registered NOMS site. To find out more about how NOMS and its FCMs relate to Medicare’s claims-based outcome reporting using G-codes, view frequently asked questions related to NOMS and claims-based outcomes reporting.
More information can be found at www.asha.org/NOMs.
Anyone interested in NOMS participation can contact their Therapy Resource or our internal NOMS liaison with ASHA: Tamala Sammons at tsammons@ensigngroup.net.
2. Continuity Assessment Record and Evaluation Item Set (CARE) for Physical and Occupational Therapists
As a part of the Medicare Post-Acute Care Payment Reform Demonstration (PAC-PRD), a standardized patient assessment tool was developed for use at acute hospital discharge and at post-acute care admission and discharge. This tool was named the Continuity Assessment Record and Evaluation (CARE) Item Set. Data collected using the CARE Item Set served as a major source of information in the demonstration. The CARE Item Set measures the health and functional status of Medicare beneficiaries at acute discharge and measures changes in severity and other outcomes for Medicare post-acute care patients.
The CARE Item Set is designed to standardize assessment of patients’ medical, functional, cognitive and social support status across acute and post-acute settings, including long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs) and home health agencies (HHAs). The goal was to standardize the items used in each of the existing assessment tools while posing minimal administrative burden to providers. The CARE Item Set builds on prior research and incorporates lessons learned from clinicians treating the continuum of patients seen in all settings. The CARE Item Set targets a range of measures that document variations in a patient’s level of care needs, including factors related to treatment and staffing patterns such as predictors of physician, nursing and therapy intensity.
Physical Therapy data collection and reporting will relate to mobility. Occupational Therapy data collection and reporting will relate to self-care.
Rehab Optima is already approved as a data collector for CARE, so our clinicians will be able to simply enter data directly into the electronic record. Rehab Optima is also working on a partnership with ASHA to be able to do the same for NOMS in the future.
To access a lunch and learn recording from Rehab Optima on this topic, click the following link and enter your email: https://www1.gotomeeting.com/register/861998488.