Introduction

Dennis Wagner & Jeneen Iwugo

An introduction from Dennis Wagner, Director, and Jeneen Iwugo, Deputy Director, Quality Improvement and Innovation Group (QIIG), Center for Clinical Standards and Quality (CCSQ), Centers for Medicare & Medicaid Services (CMS).

QIO Program Structure

How We Serve Medicare Beneficiaries

The Quality Improvement Organization (QIO) Program structure follows a functional model with two types of QIOs: Quality Innovation Network-QIOs (QIN-QIOs) and Beneficiary and Family Centered Care-QIOs (BFCC-QIOs). Fourteen regional QIN-QIOs work with providers, community partners, beneficiaries and caregivers on multiple data-driven quality improvement initiatives to improve patient safety; reduce harm; engage beneficiaries, families and caregivers; improve care and reduce health care disparities. Two BFCC-QIOs manage all beneficiary complaints and appeals across the nation, ensuring that beneficiaries are treated fairly and helping them exercise their right to high-quality health care across care settings.

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Qio Program

Year in Numbers

 In 2017, QIN-QIOs were especially successful in performing meaningful and impactful work in patient and family engagement, and achieving results in the areas of medication safety, immunizations, care coordination, diabetes care and nursing home care. BFCC-QIOs exceeded established targets for the timely review of beneficiary complaints and continued to implement resolutions that fostered beneficiary and provider engagement.

QIN-QIOs

2.3M+
beneficiaries at high risk for an adverse drug event (aDE) were screened for aDE
600K+
flu immunizations were administered by recruited clinicians and practices
47K+
beneficiaries completed diabetes self-management education and support (DSMES)

BFCC-QIOs

747,029+
Total Review volume
$48M
Cost savings achieved through Higher Weighted Diagnosis-Related Group (DRG) reviews
View 2017 Results
Qio Program

Year in Review

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Quality Payment Program Launch

The Centers for Medicare & Medicaid Services (CMS) formally launched the Quality Payment Program (QPP) in January 2017.

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Preparation for Future QIO Activities

In April, CMS held a special session to help inform the priorities of the next phase of the Quality Improvement Organization (QIO) Program.

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Kickoff of Second CMS National Nursing Home Quality Care Collaborative

The National Nursing Home Quality Care Collaborative, led by CMS and QIN-QIOs, is spreading quality and performance improvement practices.

Campaign for Meds Management: Phase II

The Quality Innovation Network National Coordinating Center (QIN NCC) launched phase two of the Campaign for Meds Management.

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Beneficiary Healthcare Navigation Program Debut

The BFCC-QIOs kicked off the Beneficiary Healthcare Navigation Program in September 2017.

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Special Innovation Project Awards

In October 2017, CMS awarded 14, two-year Special Innovation Projects (SIPs) to 11 QIN-QIOs.

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Engaging Persons and Families

In 2017, the QIO Program implemented Beneficiary & Family Advisory Councils (BFACs) across all segments of the Program.

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Celebrating 2017 Success at the 2018 CMS Quality Conference

CMS held its largest CMS Quality Conference to date, with nearly 2,600 attendees.

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Qio Program

Snapshots of Success

Special Innovation Project

Alliant Quality Uses Patient Stories to Help Emergency Department Staff Better Treat Sickle Cell Disease
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Behavioral Health

Lake Superior QIN Helps Local Clinics Use Electronic Health Records to Improve Use of Behavioral Health Screenings
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Transforming Clinical Practice Initiative

TMF Quality Innovation Network Collaborates With Other QIN-QIOs on Transforming Clinical Practice Initiative
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QIO Program

A Look Ahead

In the year ahead, the QIO Program will focus on achieving its top objectives: aligning its work with important national health care priorities and continuing to improve the quality of care for Medicare beneficiaries nationwide. Following are some of the pressing health care priorities that Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) will be helping address at the community level in collaboration with partners and other stakeholders.

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