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CMS Cuts
List of Measures for PVRP by More than Half Coalition
Releases Road Map for EHR Implementation in LTC AHQA/AHIMA
to Offer Course on Leading Change AHRQ Calls
for Topics for New ACTION Program Provider
Education Pieces Available for Oncology Demo New Publication
Aids Patients Facing Surgery AHQA Hosts
Webcast to Discuss Early Issues with Part D QIO Efforts
Give Roots to RAM Campaign Study: P4P
May Save Lives but Not Money NEJM Features
Articles on New Medicare Drug Benefit New Awards
Program Recognizes Six Sigma Accomplishments AHQA leaders
and quality improvement experts across the nation will gather in Miami
from February 20-24 at AHQA’s 2006 Annual Meeting
to share best practices and learn new techniques to improve quality in
the American health care system. Richard Norling, CEO of Premier, Inc.
will deliver the keynote address. This year’s
meeting promises unparalleled opportunities to learn about cutting-edge
techniques to assist providers with such challenging tasks as health
information technology, the new drug benefit, nursing home culture
change, and pay-for-performance (P4P). Leaders in health care quality improvement will present lessons learned
and best practices in topic tracks representing various care settings
and quality improvement methods. They include: • Nursing
Homes On Wednesday
and Thursday morning, the Centers for Medicare & Medicaid
Services (CMS) will offer a number of sessions offering QIOs the chance
to discuss SOW8 contract issues with project officers and agency leaders. In his keynote
address, Richard Norling will present results from the first national
demonstration project to pay incentives to hospitals based on quality
of care for five clinical conditions, AMI, CABG, CAP, heart failure,
and hip/knee replacement. He is expected to provide detailed results
from the project’s
first year, lessons from top-performing hospitals, and a look at the
future of P4P. Plenary Session Highlights Thursday’s
concurrent plenary sessions feature two national medical societies
talking about physician office redesign and a second concurrent session
on patient safety In the first
session, Michael Barr, MD, Vice President, Practice Advocacy and Improvement
for the American College of Physicians will join American Academy of
Family Physicians (AAFP) representatives Janet Leiker, RN, MPH, CPHQ,
Manager, Healthcare Quality, and Bruce Bagley, MD, Medical Director
for Quality Improvement to discuss two approaches to physician office
redesign. Dr. Barr will discuss how physician practices and QIOs can
utilize precepts from the Value Chain framework in office redesign,
as well as identify available resources to assist in practice redesign
for both improvement and health IT. Dr. Bagley and Ms. Leiker will describe
the AAFP’s Practice Enhancement Program which, in partnership with
local QIOs and others, provides assistance to physician practices with
redesign and quality improvement. Speakers will also discuss the potential
for ongoing collaboration with medical specialty societies. On Friday, leading experts will discuss opportunities for QIOs to become
involved in rewards programs and pay-for-performance (P4P) initiatives.
Francois deBrantes, Program Leader for GE Health Care Initiatives and
Bridges to Excellence, along with Charles Parker, MassPRO, and Ferdinand
Richards, III, MD, FMQAI, will discuss how to leverage private sector
rewards programs like Bridges To Excellence and the NCQA Diabetes Physician
Recognition Program to support QIO work in physician practices. Making
financial rewards available to DOQ-IT physicians can help drive not only
IT adoption but also transformational quality improvement, and this session
will discuss how QIOs can become involved in accelerating or creating
rewards programs in their local markets. Following the Friday morning concurrent sessions, a panel of IOM members
will present findings of their report to Congress on the QIO program.
The report, to be released earlier in the week, is one of three by the
IOM that aims to make recommendations to policymakers on improving the
American health care system. The first report, Performance Measurement:
Accelerating Improvement, was released December 1. The evaluation of
the QIO program is the second report; a report on P4P is also expected. Registration Online registration is open until January 20. Later registrants can
complete their forms onsite. Some sessions may require additional registration
fees. To register online, visit: http://registration.ahqa.org//AM/Template.cfm?Section=Home
Questions regarding registration may be directed to Amanda Scott at ascott@ahqa.org. CMS Cuts
List of Measures for PVRP by More than Half The Centers
for Medicare & Medicaid Services (CMS) has reduced the
number of “starter set” measures it will collect in the Physician
Voluntary Reporting Program (PVRP) from 36 to 16. CMS said the measures
were revised as a result of suggestions from “several physician
organizations” that the initial starter set of measures be reduced “in
order to lessen the potential reporting burden for physicians and better
align the PVRP with other quality measurement activities affecting physicians. In a January
5 article, BNA’s Health Care Daily Report, a publication
widely read by Washington policy makers, reported that “Physician
groups, including the American Medical Association, the Medical Group
Management Association, and members of the Practicing Physicians Advisory
Council, objected to some aspects, particularly because physicians will
not be reimbursed for the extra work involved.” At least
one group, the American College of Physicians (ACP) has issued a statement
supportive of the recent CMS move. In a press release, ACP termed the
revised measures as “critically important” and “essential” for
the success of the quality improvement program. The agency said it intends to refine the other 20 measures and include
additional measures suggested by physician groups in the future. The 16 measures in the PVRP core starter set are: CMS announced PVRP in October 2005 as a precursor to restructuring physician
payment based on performance on various quality measures. Physicians
participate in PVRP by adding additional codes (G-codes) to Medicare
claims forms. AHQA has been assured by CMS that it intends for PVRP to be a temporary
measure and that any permanent physician pay-for-performance program
will be accomplished through health information technology (HIT), rather
than G-codes. QIOs are working to help physicians adopt HIT in the SOW8
and have been asked to offer information on PVRP as requested by physicians. Read the announcement at: http://www.cms.hhs.gov/PhysicianFocusedQualInits/Downloads/ Coalition
Releases Road Map for EHR Implementation in LTC A coalition of 14 stakeholder groups, including AHQA, released a joint
road map recently that focuses on private and public sector efforts toward
promoting and implementing electronic health records (EHRs) and other
information technologies in long-term care (LTC) settings. The report, “A Road Map for Health IT in Long-term Care,” calls
for promotion of special projects through the QIO program to support
health IT adoption and effective implementation in LTC. Although a significant and growing portion of national health expenditures
are devoted to the care of individuals over 65 years old, current health
IT agendas and strategies are almost exclusively focused on hospital
and physician office settings. The road map, the first effort directed at EHR implementation in the
LTC setting, is the product of the first-ever LTC Health IT Summit, held
in August 2005. The summit was an important step in bringing the LTC
community together to develop a consensus and strategy for promoting
health information technology and EHRs. Representatives from more than
100 organizations developed a list of top priorities and recommendations
for the next 12 to 24 months. They include: The 14 stakeholder groups that developed the road map include: the American
Association of Homes and Services for the Aging (AAHSA) and Center for
Aging Services Technologies (CAST); American College of Health Care Administrators
(ACHCA); AHCA/National Center for Assisted Living (NCAL); American Health
Information Management Association (AHIMA); American Health Quality Association
(AHQA); American Medical Directors Association (AMDA); American Society
of Consultant Pharmacists (ASCP); Center for Health Transformation (CHT);
Home Care Technology Association of America (HCTAA); National Association
for Geriatric Nursing Assistants (NAGNA); National Association for Home
Care and Hospice (NAHC); National Association for the Support of Long
Term Care (NASL); National Program of All-inclusive Care for the Elderly
(PACE) Association; Setting Priorities for Retirement Year (SPRY). The report
is available on the AHIMA website: http://www.ahima.org/meetings/ltc/index.asp. A second LTC Summit is planned for spring or summer of 2006. For more
information, contact David Adler, Director of Government Affairs at:
dadler@ahqa.org. AHQA/AHIMA
to Offer Course on Leading Change AHQA is partnering with the American Health Information Management Association
(AHIMA) to offer a one day course on effective strategies for leading
change, in response to the unique challenge QIOs face working with partners
to improve quality on a voluntary basis, when these partners do not have
to adhere to the timeframe set forth in the QIO contract. The course
will be offered February 21, 2006, during the AHQA 2006 Annual Meeting
in Miami, Florida. In the SOW8, QIOs are required to help 5% of the primary care practices
in their state go electronic within two years. CMS will hold the QIOs
accountable for achieving this goal, but there is no federal requirement
for practices to adopt health IT in two years or less. Many change
projects fail because they do not address the emotional or “people side.” of
change. The course will help attendees develop an in-depth understanding
of both the technical processes and the emotional side of change to
enhance their effectiveness as agents of change. At the conclusion
of the one-day program, attendees will have a framework and new tools
that they can use to lead transformative change. Registration
information at: www.ahqa.org AHRQ Calls
for Topics for New ACTION Program The Agency
for Healthcare Research and Quality (AHRQ) will soon launch a new program
called “Accelerating Change and Transformation in
Organizations and Networks,” or ACTION, a successor to the Integrated
Delivery System Research Network (IDSRN, http://www.ahrq.gov/research/idsrn.htm). Like IDSRN, ACTION will promote innovation in health care delivery by
accelerating the development, implementation, dissemination, and uptake
of demand-driven, evidence-based products, tools, strategies, and findings.
According the Cynthia Palmer, AHRQ Project Officer, the new program retains
a similar structure to IDSRN but will be improved and enlarged. In preparation for this launch, the agency is now calling for project
concepts. All interested parties can submit ideas by sending a 1- to
2-page concept paper--including a brief rationale, suggested methods,
a description of how findings may improve health care delivery or outcomes,
duration (18 months maximum), and an estimated budget--to Ms. Palmer
at CPalmer2@ahrq.gov. Organizations may also sponsor projects or suggest potential cosponsors.
An external advisory panel for the network is also being developed to
help identify opportunities and provide strategic planning and goal setting
guidance at six month intervals. Those wishing to nominate one or more
experts for this panel should send name, contact information and a brief
recommendation to Ms. Palmer. Provider
Education Pieces Available for Oncology Demo The Centers
for Medicare & Medicaid Services (CMS) recently published
two Special Edition Medlearn Matters articles that provide detailed information
for providers on the new 2006 Medicare Oncology Demonstration Project.
Medlearn Matters articles are part of the Medicare Learning Network designed
to provide timely, easy-to-understand educational materials for providers
about Medicare’s new programs. The 2006 Medicare Oncology Demonstration Project is designed to identify
and assess oncology services that positively affect outcomes in the Medicare
population. The one-year project is being conducted in office-based oncology
practices. The first article on this project, SE0589, provides Medicare policy
and claims processing information applicable to the demonstration; the
second article, SE0588, provides information on documentation and coding
guidelines. The articles are available online at: More information on the Medicare Learning Network is available at: http://www.cms.hhs.gov/MedlearnMattersArticles/ New Publication
Aids Patients Facing Surgery The Agency
for Healthcare Research and Quality recently released a new patient-directed
publication, “Having Surgery? What You Need to
Know,” to help patients make informed decisions about surgical
procedures. The brochure suggests questions to help patients obtain needed information,
including how and where their operation will be performed, what kind
of anesthesia will be used, if non-surgical medical treatment and watchful
waiting are options, possible risks of not having the surgery, potential
risks and expected benefits if they have the surgery, and how long recovery
is expected to take. Other questions
in the brochure help patients determine whether and how much of the
cost of the operation will be covered by their insurance; whether a
second opinion is required and/or covered; how they can learn the surgeon’s
qualifications for and experience with their particular procedure;
and how to find out how many times the procedure has been performed
in the hospital the surgeon suggests, or in other hospitals if patients
have a choice of where to go for the operation. The publication is part of a series of health care resources from AHRQ
to help people become more active in making informed decisions that can
help them obtain high quality health care. The brochure is available online: English version: http://www.ahrq.gov/consumer/surgery/surgery.htm
and Spanish version: http://www.ahrq.gov/consumer/spsurgery/spsurgery.htm. To order free single copies, call the AHRQ Publications Clearinghouse
at (800) 358-9295 or send an e-mail to ahrqpubs@ahrq.gov. AHQA Hosts Webcast to Discuss Early Issues with Part D AHQA joins the American Association of Colleges of Pharmacy (AACP),
the American Pharmacists Association (APhA), and the National Council
of State Pharmacy Association Executives (NCSPAE) in hosting a live,
interactive webcast examining early issues and critical questions about
the new Medicare prescription drug benefit, which took effect January
1. “Medicare Prescription Drug Benefit – Early Lessons and
Next Steps in Implementation and Evaluation,” will be held Monday,
January 23, 2006 at 1-3 pm ET, 12-2 pm CT, 11am -1 pm MT, 10 am -12 noon
PT. Speakers
include: Who should
attend? Registration is $100 per site. To register online go to: http://gateway.ilearning.com/aacp/
and follow these directions: For more information, contact Lisa Croce at lcroce@ahqa.org. QIO Efforts Give Roots to RAM Campaign As part of the Remaking American Medicine (RAM) campaign, QIOs across
the country are partnering with their local PBS stations and health care
stakeholders to promote improved health care in their communities. The
RAM series is expected to air on PBS in the middle of this year. Florida The Florida
QIO, FMQAI, and PBS station WEDU in Tampa
held a “Diabetes and You” event in September
2005 with coalition partners, as well as the American Diabetes Association
(ADA), Steps to a Healthier Florida, and the West Central Florida Area
Agency on Aging, Inc. At the the event, local and national experts addressed diabetes prevention
in the Hispanic community. This was followed by the taping of a 30-minute
roundtable discussion where experts provided information on how patients
can best manage the disease. A phone bank of volunteers from the ADA
also answered viewer calls. The program
aired in September, and will be broadcast several times prior to the
premiere of the RAM series. Outreach activities will be coordinated
around each program to promote the campaign and the RAM series. Streaming
video of the program will be posted on participating organization’s
websites and will also be made available to all Florida PBS stations. Colorado In Denver,
Rocky Mountain PBS is working with the Anti-Defamation League and the
state’s
QIO, Colorado Foundation for Medical Care (CFMC), on an outreach project
called Healthy Impact! The project is designed to create awareness
of how patients can overcome barriers in their interactions with health
care providers. With a special focus on minority populations, the coalition plans to
address the training of medical and nursing students, recruitment of
health professionals from minority communities, improving data collection
regarding health disparities, and providing language interpretation services
for patients with limited English proficiency. Rocky Mountain PBS will produce two specials on Health Impact! and Remaking
American Medicine for its weekly public affairs program Colorado State
of Mind. The station also plans to host a community Teleconference Summit. Michigan Detroit
Public Television (DPTV) and MPRO, Michigan’s QIO, are
partnering to address issues of health literacy for underserved populations.
The local coalition includes the Henry Ford Health System, Wayne State
University, Detroit Medical Center, St. John’s Health, the American
Medical Association and the State of Michigan’s Surgeon General’s
office. DPTV will
produce a 30-minute program, “To Help You Heal,” and
will feature the efforts of Champions of Change to reduce health disparities
and improve the quality of care. The program will include a panel discussion
with providers taking questions from viewers and directing them to tools
and resources about patient- and family-centered care. Subsequently,
copies of the program will be distributed to physicians throughout the
state. DPTV also plans to produce a teleconference for providers that will
include a panel discussion with experts providing strategies on how to
improve communication with patients. Providers can participate via telephone
and the Internet. Produced by Crosskeys Media, Remaking American Medicine aims to demonstrate
what transformed care can mean to all Americans by presenting advances
in the quality of patient care and compelling profiles of providers and
patients who are working together to foster fundamental change in health
care delivery. For more
information on the RAM campaign, contact Richard Deutsch at rdeutsch@ahqa.org. Study: P4P May Save Lives but Not Money In a December
2005 study, “Variation in Use of Medicare Services
among Regions and Selected Academic Medical Centers: Is More Better?” John
E. Wennberg, MD, MPH, director of the Center for the Evaluative Clinical
Sciences at Dartmouth Medical School, finds that pay for performance
(P4P) initiatives will “very likely increase the use and quality
of effective care and save lives,” but the efforts are “unlikely
to have a major impact on rising costs.” The study, sponsored by
the Commonwealth Fund is available at: http://www.cmwf.org/usr_doc/874_wennberg_variation_medicaresvcs.pdf Current
improvement efforts, Wennberg explains, are focused on “stemming
the underuse of ‘effective care’” as defined by medical
literature while most of the expense in health care comes from “preference-sensitive
care” and “supply-sensitive care,” which are not affected
by underuse. Wennberg
suggests that preference-sensitive care, which involves the communication
of treatment options with significant trade offs that require consideration
of a patient’s values, is misuse. This type of care
could benefit from economic incentives that “reward adopters of
shared decision-making,” he reports. NEJM Features
Articles on New Medicare Drug Benefit The December
29th issue of The New England Journal of Medicine (NEJM) features several
articles on the new prescription drug benefit, including an article
co-authored by Centers for Medicare & Medicaid Services
(CMS) administrator, Mark McClellan, MD, PhD, and his senior advisor,
Peter B. Bach, MD, MAPP. In their
article, “Medicare Drug Benefit: A Prescription for a
Modern Medicare Program,” McClellan and Bach call on physicians
to help Medicare patients decide which plan is right for them. CMS is
helping by providing tools and a course that will provide CME credit.
The authors suggest that the new benefit will “support physicians’ efforts
to work with patients to prevent disease and its complications.” Other articles
on the new drug benefit include: “Promise and Perils
for Patients and Physicians” by Richard L. Kravitz, MD, MSPH, and
Sophia Chang, MD, MPH; “Medicare Drug Benefit: Benefits and Consequences
for the Poor and the Disabled” by R.A. Elliott, PhD, et al; and “Medicare
Drug Benefit: A Beneficial Side Effect of the Medicare Drug Benefit” by
R. Platt, MD, and A. Ommaya ScD, who suggest that the new drug benefit
may unintentionally create “the world’s most valuable resource
for understanding how drugs are used, especially by the elderly and the
chronically ill.” All NEJM articles on the new drug benefit are available free of charge
to the public at: http://content.nejm.org/content/vol353/issue26/index.shtml New Awards
Program Recognizes Six Sigma Accomplishments The Global
Six Sigma Awards program – www.tgssa.com – was
recently launched with a call for entries in eight possible categories:
manufacturing, service & transitional environments, health care,
financial services, government & defense, integrating Lean and Six
Sigma design, innovation, and compliance. Open to organizations worldwide,
the awards program is sponsored by WCBF- Six Sigma Solutions, which sponsors
Six Sigma conferences. The Global Six Sigma Awards aim to identify the most outstanding business
achievements through the application of Six Sigma. The program will be
judged by an independent panel of Six Sigma experts, including Subir
Chowdhury and Six Sigma practitioners from organizations across the full
industry spectrum. • A
Platinum Award for the most outstanding business achievement from all
the nine organizational categories.  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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