Quality Update for July 13, 2006

Grassley Article Highlights Plans for Nonprofit Reform Public/Private Collaboration Aims to Improve Chronic Care of Aging Case Study of Public Reporting of Patient Satisfaction Data Offers Lessons Learned New on the RAM Website LTC Clearinghouse Expected in Late September New Version of HH Beneficiary Notice Available for Comment NMMRA Initiates State Coalition on Drug Improvement MPRO Researchers Join Others in Authoring Journal Article on AMI Grassley Article Highlights Plans for Nonprofit Reform The July 12 issue of The Hill features a special report, Taxes and Banking, which includes an article penned by Senator Charles Grassley (R-IA), Chairman of the Senate Finance Committee and Vice Chairman of the Joint Taxation Committee. In “Strengthening the Nonprofit Sector,” Senator Grassley explains that his reform efforts stem from his belief that philanthropy, a deeply held American tradition, should be strengthened to ensure its viability for future generations. For nearly 40 years, tax breaks for nonprofits have gone largely untouched while the nonprofit sector has continued to grow -- as has the “temptation to exploit charities for personal gain,” wrote Grassley. In an effort to protect public monies from “more than a few bad actors,” the Senator, working with the IRS and others, developed a legislative package designed to strengthen charitable giving and tighten the “rules and regulations governing the nonprofit sector” to help “repair the breach of trust that threatens to tarnish even the most reputable charities in America.” Noting that “nonprofit organizations must earn the privilege to keep their tax-exempt status” and that “Congress [must] demand transparency, accountability and good governance from the nonprofit sector,” Senator Grassley highlighted several areas of concern “based on my congressional investigation to track the abuse and misuse of tax-exempt organizations.” They include: Excessive compensation and perks. Nonprofits that operate like businesses, not charities. Inappropriate political activity. Lack of financial transparency and accountability. Nonprofit hospitals that do not provide adequate charity care and community benefits. Tax-exempt organizations fronting as tax-shelters. Donor-advised funds and supporting organizations being used by the wealthy to protect business assets and take charitable tax deductions with little or no money actually going to public charities. Charitable boards that are not engaged in their fiduciary responsibilities. Read the article at: http://thehill.com/thehill/export/TheHill/News/Frontpage/071206/ss_grassley.html Back to top Public/Private Collaboration Aims to Improve Chronic Care of Aging Health and Human Services (HHS) Secretary Mike Leavitt recently announced a $15 million collaboration with The Atlantic Philanthropies to improve the health and quality of life for older Americans at the community level. The collaboration, known as “Empowering Older People To Take More Control of their Health Through Evidence-Based Prevention Programs” is a public/private partnership that aims to speed the adoption of “best practices” proven to reduce the incidence and improve management of chronic diseases and conditions in the aging population. HHS, through the Administration on Aging, will award competitive grants to 12 states totaling up to $300,000 per project for each year of a three year period; a 25% match will be required. States are expected to mobilize public/private partnerships that will support the delivery of evidence-based programs for seniors at the community level through non-profit aging services, such as senior centers, nutrition programs, senior housing projects, and faith-based organizations. At least 30 local communities will have programs up and running within a year. Only one application per state may be submitted by a State Aging Agency or State Health Department. A letter of support from the Governor’s office is also required. Grant applications can address one of the following issues: Chronic Disease Self-Care (i.e., chronic diseases generally or specific ones such as diabetes, hypertension, heart disease, arthritis, etc.) Physical Activity Fall Prevention Nutrition and Diet (including the role of nutrition in the maintenance of healthy and appropriate body weight and control of chronic diseases, etc.) Mental Health and/or Substance Abuse Prevention (including early intervention for depression, anxiety, alcohol misuse or medication misuse). Applications can be submitted online at www.grants.gov by midnight Eastern, August 31, 2006. Grants will be awarded by September 30, 2006. In addition, through a grant of up to $5 million to the Center for Healthy Aging, The Atlantic Philanthropies will provide additional financial support and technical assistance in up to five states that show significant potential in developing systems to reach large numbers of older adults. The Atlantic Philanthropies (www.atlanticphilanthropies.org) is a non-profit, limited-life foundation that is committed to spending its entire multibillion-dollar endowment by 2020 to bring about lasting changes in the lives of disadvantaged and vulnerable people. For more information and a program announcement about the collaboration, visit http://www.aoa.gov/doingbus/fundopp/fundopp.asp or call 202-357-0136. Case Study of Public Reporting of Patient Satisfaction Data Offers Lessons Learned The June issue of Health Services Research includes the article “Using Public Reports of Patient Satisfaction for Hospital Quality Improvement,” authored by Qualidigm staff and others. It analyzes the impact of patient satisfaction surveys on hospital quality improvement efforts. Qualidigm is the QIO for Connecticut. The study evaluated the impact of mandatory statewide public reporting of patient satisfaction on hospital quality improvement efforts, including identification of facilitators and barriers. Its findings offer lessons for other states or regions embarking on public reporting of patient satisfaction data. Public reporting of clinical performance and patient satisfaction was mandated in Rhode Island in 1998 to enhance public accountability and promote quality improvement in licensed health care facilities. More recently, the Centers for Medicare & Medicaid Services has implemented a standardized survey tool (HCAHPS) to begin measuring patient satisfaction with the intent to publicly report findings. In this study, researchers interviewed hospital executives at all 11 general and two specialty hospitals between September 2002 and January 2003. They found that public reporting of patient satisfaction data can “enhance and reinforce QI efforts in hospitals” by identifying opportunities for improvement and promoting sharing of best practices to address common problems. The majority of survey respondents said that organizational commitment drove quality improvement efforts. The authors wrote that respondents indicated the greatest degree of support came “from the board and senior management and the least support from the medical staff.” The study was authored by Marcia Petrillo, CEO; Judith Barr, ScD, Senior Scientist; and Tierney Giannotti, MPA, Senior Research Associate all of Qualidigm, Shoshanna Sofaer, DrPH, The City University of New York; Cathy Duquette, PhD, RN, Newport Hospital, Newport, RI; and WilliamWaters, Jr., PhD, Rhode Island Department of Health. It is available online at: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1475-6773.2006.00508.x Back to top New on the RAM Website Four website banners are now available for download at: http://ramcampaign.org/pages/presskit_web_banners.htm. Each banner is 760 x 97 pixels and can be used on websites or published documents. Other press materials, logos, and features on champions of change are available in the online press kit at: http://ramcampaign.org/pages/pressRoom.htm Two new champions of change stories are featured on the site: By setting quality health care as his goal, John Moran, turned around Sac-Osage Hospital in Osceola, Missouri, which was on the verge of closing its doors. At Summerlin Hospital Medical Center in Las Vegas, Nevada, CEO Tim Hingtgen instigated improvements by promoting open communication and cooperation with hospital staff and physicians. Working with HealthInsight, the Nevada QIO, Summerlin became the first of only six hospitals in the region selected to participate in the Surgical Care Improvement Project. Find tools and resources from QIOs partnering with PBS stations to promote Remaking American Medicine at: http://ramcampaign.org/pages/QIO-PBS_Special_Study_Deliverables.htm Don’t forget -- the series Remaking American Medicine™…Health Care for the 21st Century is scheduled to air on local PBS stations every Thursday night in October at 10 p.m. local time. Each one-hour program features champions of change working to transform the American health care system. Back to top LTC Clearinghouse Expected in Late September A National Clearinghouse for Long-Term Care Information is expected to be operational by mid to late September. The clearinghouse, which was mandated in Section 6021(d) of the Deficit Reduction Act passed in December 2005, is a collaboration of the Administration on Aging, Centers for Medicare & Medicaid Services, and the Office of the Assistant Secretary for Planning and Evaluation with the National Governors Association. It consists of two components – the National Clearinghouse website and the Long-Term Care Awareness Campaign. When activated, the website will provide information and tools needed to plan for long-term care, as well as information on Medicaid and state partnership long-term care programs. The Campaign, known as Own Your Future, asks Governors to develop and implement state campaigns to promote awareness in their state of the need to plan for long-term care and ways to do so. For more information on Own Your Future, visit: http://www.aoa.gov/LTC/index.asp Back to top New Version of HH Beneficiary Notice Available for Comment CMS has revised the Home Health Advance Beneficiary Notice (HHABN) form and instructions taking into account recent public comments. The revised form is now available online for additional public comment. The new version reflects suggestions received during the initial comment period, which ended May 23. It is available online for another round of public comment, which ends July 24: http://frwebgate5.access.gpo.gov/cgi-bin/waisgate.cgi?WAISdocID=812544508663+2+0+0&WAISaction=retrieve Written comments and recommendations must be mailed or faxed to the OMB desk officer at: OMB Human Resources and Housing Branch, Attention: Carolyn Lovett, New Executive Office Building, Room 10235, Washington, DC 20503. Fax Number: (202) 395-6974. Questions may be directed to: Elizabeth.Carmody@CMS.HHS.GOV. Back to top NMMRA Initiates State Coalition on Drug Improvement The New Mexico Medical Review Association (NMMRA) recently initiated the New Mexico Prescription Improvement Coalition (NMPIC), a group of more than 20 health care provider groups, pharmacies and health plans offering Medicare Part D options, pharmacy and medical professional organizations, and governmental agencies designed to reduce the negative health effects associated with inappropriate drug treatment in Medicare beneficiaries. NMMRA is New Mexico’s QIO. A steering committee will set policy and direction for the coalition including the development of a strategic plan, coordination of workgroup activities, and approval of clinical medication treatment guidelines. Five workgroups will address the coalition’s goals: Clinical workgroup -- charged with developing community-wide care delivery and medication therapy management standards and creating various tools for physician offices and pharmacies. Data workgroup -- charged with using care delivery standards to establish a common, mutually agreed upon set of performance measures that will be collected across all health plans, set up a reporting template, and collect and analyze data from the health plans. Education workgroup -- charged with reviewing relevant topics on e-prescribing and medication management for health care professionals, developing publications for distribution on specific aspects of medication management and e-prescribing and conducting educational events. HIT workgroup -- charged with developing and promoting a statewide strategy on e-prescribing, providing technical support to organizations interested in adopting e-prescribing, organizing regional e-prescribing and medication therapy management forums, and promoting the sharing of best practices and experiences in e-prescribing. For more information, contact Anna Dykeman at adykeman@nmqio.sdps.org Back to top MPRO Researchers Join Others in Authoring Journal Article on AMI The June 12 issue of Archives of Internal Medicine includes the article “Sex Differences in the Application of Evidence-Based Therapies for the Treatment of Acute Myocardial Infarction,” written by MPRO staff Canopy Roychoudhury Phd, Benrong Chen, PhD, Patricia Baker, MS and other researchers. MPRO is the QIO for Michigan. The article discusses the relative benefits of the Guidelines Applied in Practice (GAP) program in men and women. The GAP program is a collaborative involving MPRO, the American College of Cardiology, and local health care coalitions, which seeks to implement national AMI standards into every day clinical practice. The researchers found that the GAP program increased the use of evidence-based therapies in male and female patients. It was also determined that the GAP discharge tool may decrease mortality rates at one year in patients with AMI, but the tool was used less often with women. “What we concluded was that greater use of the GAP discharge tool in women might narrow the post-Michigan sex mortality gap,” said Dr. Roychoudhury. To learn more contact Dr. Roychoudhury at: CRoychou@mpro.org. An abstract of the article is available at: http://archinte.ama-assn.org/cgi/content/abstract/166/11/1164 Back to top

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