Coming to Terms With the IMPACT Act of 2014

The Improving Medicare Post-Acute Transformation (IMPACT) Act of 2014 will set the course for much of postacute care well into the next decade. It (1) authorizes a uniform method of patient assessment in postacute care; (2) sets a timetable for developing, implementing, and reporting quality measures; and (3) lays the groundwork for future payment reform in postacute care. This article places the IMPACT Act into the larger arc of health care reform and change. It summarizes the law’s key provisions and presents a contrarian analysis of this much-heralded bipartisan legislation. The Affordable Care Act (ACA) of 2010 already gives the Centers for Medicare and Medicaid Services the authority to implement what the IMPACT Act requires. The IMPACT Act may even slow down the changes envisioned in the ACA. The article concludes by noting the implications for occupational therapy both as a practice and a profession.