The Centers for Medicare & Medicaid Services (CMS) formally launched the Quality Payment Program (QPP) in January 2017. Throughout 2017, CMS made efforts to reach all Eligible Clinicians, including by implementing an education initiative for rural practices to ensure that small physician practices could transition smoothly to new payment models. Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) have provided technical assistance to large practices participating in the Quality Payment Program and are supporting CMS's efforts to reduce provider burden. For example, QIN-QIOs are helping clinicians select meaningful measures that align with their patient populations and participation in other reporting programs, and are providing timely, informed responses about QPP requirements.
In April, CMS held a special session at CMS's headquarters in Baltimore, Maryland—simultaneously webcast for other health care quality stakeholders nationwide—to help inform the priorities and aims of the next phase of the Quality Improvement Organization (QIO) Program, known as the 12th Scope of Work, beginning on August 1, 2019. Executives from the CMS Center for Clinical Standards and Quality’s Quality Improvement and Innovation Group sought stakeholder input on emerging goals and approaches, like how to maximize national impact while empowering state flexibility and local leadership. Click here to view presentations from the special session, listen to a recording or download an audio transcript. Additional feedback can be submitted to QIOProgram@cms.hhs.gov.
The National Nursing Home Quality Care Collaborative, led by CMS and QIN-QIOs, is spreading quality and performance improvement practices in nursing homes serving beneficiaries; working to eliminate health care-acquired conditions (HACs); and improving resident satisfaction by focusing on the systems that impact quality. By the start of the second collaborative in April 2017, known as Collaborative II, more than 12,200 nursing homes (more than 78 percent of all nursing homes in the nation) had joined the collaborative. That number includes more than 2,600 nursing homes with a one-star rating in CMS’s Five Star Quality Rating System, representing the nursing homes that are most in need of quality improvement. Collaborative II is building upon successes and lessons learned through sharing of best practices by QIN-QIOs.The second collaborative supports the creation of a culture of resident safety in nursing homes. QIN-QIOs are providing participating nursing homes with training in TeamSTEPPS; antibiotic stewardship principles and practices; and Clostridium difficile (C. diff) management and prevention techniques. Older adults who take antibiotics and receive medical care are particularly at risk for developing C. diff infections, which can be deadly. In coordination with the Centers for Disease Control and Prevention (CDC), QIN-QIOs are helping nursing homes collect and report infection data to the CDC’s National Health Care Safety Network database to establish a national baseline for C. diff infections in nursing homes.
The Quality Innovation Network National Coordinating Center (QIN NCC) launched phase two of the Person and Family Engagement program for medication safety: the Campaign for Meds Management (CMM). The CMM is a national effort that aims to learn from beneficiaries and their experiences, and that shares person-centered resources and information to help achieve better health care outcomes and reduced adverse drug events. The initiative hosts frequent national learning events that feature beneficiaries, beneficiary advocates and caregivers who want to share their experiences and health care journeys so that others can learn and be inspired to do more. Learn more at http://qioprogram.org/campaign-meds-management.
The Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIOs) kicked off the Beneficiary Health Care Navigation Program in September 2017, helping beneficiaries with complex health care needs make their way through difficult medical systems and treatments. The navigators—including nurses, social workers and others—assist with health care coordination in various settings such as physician offices, hospitals and nursing homes.
In October 2017, CMS awarded 14, two-year Special Innovation Projects (SIPs) to 11 QIN-QIOs. Projects were required to address issues of quality occurring within the QIN-QIOs’ local service area or focus on expanding the scope and national impact of quality improvement interventions that have proven but limited success. SIPs cover a range of topics, including opioids, obesity and behavioral health. Read more about a SIP led by Alliant Quality QIN-QIO.
CMS is committed to integrating Person and Family Engagement (PFE) into policy and program development through its Person and Family Engagement Strategy. In 2017, the QIO Program implemented Beneficiary and Family Advisory Councils (BFACs) across all segments of the Program, empowering Medicare beneficiaries to take an active role in managing their health and health care services.
The Beneficiary and Family Centered Care National Coordinating Center’s BFAC uses the personal perspectives and experiences of its members to add an end-user perspective to the BFCC-QIO work, such as the rollout of the recently added Beneficiary Health Care Navigation services. The Council is the representative voice of millions of people who receive Medicare benefits. The examples and feedback from advisors shape the BFCC-QIOs’ efforts toward person-centeredness in all beneficiary engagement projects, while also supporting the core value of BFCC-QIOs—protecting Medicare beneficiary rights.
The Quality Innovation Network National Coordinating Center’s BFAC incorporates the diverse perspectives of its members from across the country into quality improvement initiatives, like the Program’s Campaign for Meds Management. The Council also offers valuable and actionable feedback to QIN-QIOs, which meaningfully includes Medicare beneficiaries in their work locally.
At CMS’s largest-ever gathering of health care quality stakeholders, CMS leadership discussed the Agency’s “Patients Over Paperwork” initiative, which is designed to reduce unnecessary burden on providers, enabling them to spend more time with CMS beneficiaries across settings of care. Attendees shared and celebrated successes from 2017, and CMS officials highlighted their 2018 and long-term roadmap to tackle the opioid epidemic; convened a diverse panel of beneficiaries, advocates, caregivers and clinicians sharing stories on "Putting Patients First"; and presented the first-ever Health Equity Awards.