In 2017, QIN-QIOs were especially successful in performing meaningful and impactful work in person 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 are working to combat antibiotic resistant bacteria by increasing awareness of the importance of proper antibiotic use and delivering technical assistance that builds the capacity of outpatient providers to monitor, reduce and prevent misuse and/or overuse of antibiotics.
Six regional QIN-QIOs provide technical assistance and educational interventions to help primary care providers screen for and increase the identification of people with alcohol use disorder and/or depression. In addition, QIN-QIOs work with inpatient psychiatric facilities to improve transitions of care and reduce readmissions for these and other patients after discharge.
QIN-QIOs work to implement evidence-based practices to improve cardiovascular health and support the Million Hearts® initiative’s goal to prevent one million heart attacks and strokes by 2022.
QIN-QIOs help providers and communities reduce avoidable hospital admissions and readmissions by improving the quality of care transitions.
QIN-QIOs work to provide diabetes self-management education and support to beneficiaries, including in minority, rural and impoverished communities; improve clinical outcomes; and increase adherence to clinical guidelines. QIN-QIOs also provide technical assistance to participating practices, partners and other stakeholders interested in developing sustainable diabetes education programs through Medicare.
QIN-QIOs work to improve immunization rates among minority and underserved populations in 37 states and territories nationwide (based on greatest need), helping increase their rates of influenza and pneumonia vaccinations.
QIN-QIOs work to improve medication safety and to reduce or prevent adverse drug events via improvement processes and education on proper medication use and patient engagement.
Through the National Nursing Home Quality Care Collaborative, now in its second phase and known as Collaborative II, QIN-QIOs seek to eliminate health care-acquired conditions and ensure that every nursing home resident has the highest quality of care. In Collaborative II, QIN-QIOs will provide participating nursing homes with training in strategies and tools to enhance performance and resident safety; antibiotic stewardship principles and practices; and Clostridium difficile management and prevention techniques. QIN-QIOs also will join with their state coalitions that work with and support the National Partnership to Improve Dementia Care in Nursing Homes and encourage nursing homes to actively engage with them to reduce antipsychotic medication use.
QIN-QIOs provide Quality Payment Program (QPP) technical assistance (TA) to groups of 16 or more Eligible Clinicians. This TA includes support that allows Eligible Clinicians to easily comply with their QPP requirements, such as meeting reporting requirements, successfully submitting data and utilizing appropriate feedback reports. QIN-QIOs also support the ability of hospitals and clinicians to report quality data to CMS through various quality reporting programs, consequently helping providers use data to drive improvement.
The Transforming Clinical Practice Initiative (TCPI) is preparing 140,000 clinicians for successful participation in Medicare Alternative Payment Models like Accountable Care Organizations and bundled payment programs. QIN-QIOs partner with the Practice Transformation Networks in their region to assess the progress of participating practices through the five phases of practice transformation. The QIN-QIOs assess progress by conducting baseline and ongoing assessments.
Numbers are based on the most recent
data sources available to the Quality
Innovation Network National Coordinating Center as of January 31, 2018, unless otherwise noted.
* Data reported for Calendar Year 2016, as reported annually in July 2017.
** To receive reimbursement from Medicare for the Medicare diabetes self-management training benefit, a diabetes education program must achieve either AADE accreditation or ADA recognition.
*** Potential ADEs (pADEs) are reported by QIOs quarterly, and an individual beneficiary may have multiple pADEs per quarter.
**** More than 300,000 MIPS Eligible Clinicians (eligible as individuals or as part of a group practice) will need to be reached by the QIN-QIOs as part of the target population for the 2017 transition year in the QPP.
$48,277,788 Cost savings achieved through Higher Weighted Diagnosis-Related Group (DRG) reviews
747,029 Total Review Volume
BFCC-QIOs conducted more than 40,000 reviews for quality of care concerns and identified more than 23,007 opportunities for quality improvement across a variety of health service providers. The primary quality of care concern, representing 17% of concerns identified, was not establishing an appropriate treatment plan. More than 494,443 discharge appeal reviews were completed, resulting in more than 99,000 beneficiaries not being discharged earlier than necessary.
BFCC-QIOs worked in partnership with QIN-QIOs to perform and report more than 1,606 successful Quality Improvement Initiatives (QIIs) that improve health care quality by assisting providers and/or practitioners with identifying the root cause of a concern, develop a framework in which to address the concern, and improve a process or system.
Numbers are based on the most recent data sources available to the Beneficiary and Family Centered Care-National Coordinating Center as of January 31, 2018.