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Quality Update for September 14, 2006


Quality Update for September 14, 2006

QIOs Gear Up for Remaking American Medicine

CMS Launches My Health. My Medicare

Demo: Hospitals Pay MDs to Improve Patient Outcomes

AHRQ Study: Nurse-Led Care Benefits HF Patients

CDC Makes New Flu Materials Available

Quality Summit To Kick Off National Nursing Home Campaign

QIOs Gear Up for Remaking American Medicine
National PBS Series Airs Thursday Evenings in October

QIOs across the country are ramping up efforts to promote Remaking American Medicine…Health Care for the 21st Century (RAM), a PBS documentary series produced by CrossKeys Media that showcases inspiring stories of change driven by health care providers and patients working together to fundamentally improve the nation’s health care system. The culmination of a five-year effort, the series is scheduled to air on local PBS stations on four consecutive Thursday evenings throughout the month of October. Both AHQA and its sister foundation have actively supported this effort throughout those five years.

TUNE IN!

Check local listings for times:

October 5:
Program One - “Silent Killer” Medical errors

October 12:
Program Two - “First Do No Harm” Nosocomial infections

October 19:
Program Three - “The Stealth Epidemic” Chronic diseases

October 26:
Program Four - “Hand in Hand” Patient-Caregiver communication

National Symposium
The Amgen Foundation is sponsoring “Champions of Change: A National Symposium in Improving Health Care,” which will take place in Washington, D.C. on September 27, 2006. National health care quality leaders will honor the work of the individuals and institutions that are transforming American health care in communities across the country.

Journalist John Hockenberry will host the event. Keynote speakers include:
• Mark McClellan, MD, PhD, Administrator, Centers for Medicare & Medicaid Services
• Donald Berwick, MD, MPP, president and CEO, Institute for Healthcare
• Improvement
• Carolyn Clancy, MD, Director, Agency for Healthcare
• Research and Quality

The symposium is invitation only, but it will be distributed via webcast and satellite feed to PBS stations. Viewers are encouraged to send in questions. The webcast will be available at www.kaisernetwork.org/ram2006. Information, links, and a complete agenda are available at www.RAMcampaign.org.

In addition to sponsoring the national symposium, the Amgen Foundation provided underwriting to launch two new consumer-oriented Web sites to support the RAM series broadcast:
www.pbs.org/remakingamericanmedicine was launched Thursday, September 14 and
www.remakingamericanmedicine.org is expected to be available soon.

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More on Local RAM Efforts Led by QIOs
Previous stories and RAM newsletters have described the key role of QIOs in about twenty states, and here is information about a few more.

Primaris, the Missouri QIO, is working with KETC/St. Louis to organize a live studio event to promote local participation in the national symposium. Guests, including statewide coalition members, quality health care experts and other community activists will discuss health care issues of interest to Missourians.

Focusing on chronic disease management, HealthInsight, the QIO for Nevada and Utah, and its local PBS station, KUED-TV, will host a communitywide screening event and panel discussion in conjunction with the third RAM series, “The Stealth Epidemic.” KUED’s public affairs series, Utah Now, is also featuring local “Champions of Change” that are committed to chronic disease management.

Health Care Excel, the Indiana QIO, is partnering with local PBS station WFYI, to engage other RAM coalition members such as the Indiana School of Medicine, Riley Children’s Hospital, and the Central Indiana Council on Aging in continuous outreach efforts to help patients and families become stronger advocates for their own health care. Health care forums, community-wide screening events, and promotion of RAM on partner websites and publications, including monthly consumer health care tips are some of the strategies employed. WFYI is also producing four television spots around the series.

For updates and information, visit www.RAMcampaign.org.

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CMS Launches My Health. My Medicare

Reflecting the agency’s focus on prevention, the Centers for Medicare & Medicaid Services (CMS) recently kicked off its My Health. My Medicare. Campaign at an event in Washington. The Campaign aims to help new and existing beneficiaries understand, evaluate, select, and use their benefits, including the new prescription drug benefit, for which fall enrollment begins November 15. CMS is calling on its partners to help reach out to Medicare beneficiaries to promote the messages of its Campaign.

Key Dates for Medicare Beneficiaries and Partners

October 1: Plans begin marketing.

Mid-October: 2007 Plan Data and enhanced Plan Finder available.

October 31: Annual Notice of Change and Medicare & You Handbook mailed to beneficiaries.

November 15th: Open enrollment begins.

December 8th: Deadline for drug plan enrollees to ensure new prescription drug cards available by early January.

December 31st: Open enrollment ends.

“My Health. My Medicare. is the next step in helping the 43 million Americans with Medicare make the most of their benefits, so they can stay healthier and spend less on their medical care,” said Mark McClellan, MD, PhD, CMS Administrator. “By providing personalized assistance – online, on the phone and in person, with the help of partners all across the country -- we can help beneficiaries and their families make informed and confident choices about their health and Medicare coverage.”

The Campaign urges beneficiaries to take action in each of the four fall months to review available coverage, determine personal medical needs, and select appropriate plans:

  • September – compare health needs to existing coverage and ask questions about coverage.
  • October – evaluate available benefits using the one-page Medicare Checkup as a guide.
  • November – choose a new plan or change plans.
  • December – maximize benefits by working with a physician to develop a personalized plan for prevention.

Providers and other partners that worked with CMS to help beneficiaries sign up for the prescription drug benefit are being mobilized to assist with this Campaign. Tools and resources are available on the CMS website: http://www.cms.hhs.gov/MyHealthMyMedicare/01_Overview.asp

More than 38 million Medicare beneficiaries have already signed up for prescription drug coverage. Those that wish to change prescription drug plans have six weeks, between November 15 and December 31, to review other plan options and make a change. To ensure that new prescription drug cards are in hand by early January, CMS suggests that beneficiaries to sign up for new plans before December 8.

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Demo: Hospitals Pay MDs to Improve Patient Outcomes

The Centers for Medicare & Medicaid Services (CMS) recently announced the Physician-Hospital Collaboration Demonstration (PHCD), a three-year demonstration program to examine whether allowing hospitals to provide financial incentives for physicians to support better care can improve patient outcomes without increasing costs. The project is expected to begin in 2007.

PHCD requires physicians and hospitals to work collaboratively to improve patient care and outcomes while reducing costs. Patients will be tracked for an entire episode of care, which generally extends well beyond a hospitalization, to determine the impact of hospital-physician collaborations on preventing short and longer-term complications, duplication of services, and coordination of care across settings. For example, incentive payments to surgeons for achieving lower infection rates and fewer readmissions with complications could both improve patient outcomes and lower overall hospital and Medicare costs.

The hospital would receive its usual inpatient rate for care provided, but would pay physicians a portion of the savings resulting from documented, significant efforts to improve care. PHCD will involve physician groups and up to 72 hospitals in a limited number of geographic areas across the country.

“We will give preference to proposals submitted by a health care group consortium, composed of health care groups and affiliated hospitals, because we need a sufficiently large demonstration size to reliably measure impacts on longer-term patient results and overall Medicare costs,” said CMS Administrator Mark McClellan, MD, PhD. “This is very different from traditional ‘gainsharing’ with its short-term focus. We are aiming to support the best efforts of physicians and hospitals to improve quality and efficiency in the overall care for their patients.” A consortium may consist of health care groups and up to 12 of their affiliated hospitals in a single geographic area comprising no more than one state.

PHCD is authorized under Section 646 of the Medicare Modernization Act of 2003, which is designed to promote higher-quality, better coordinated care.

More information on PHCD, including a fact sheet, solicitation, and application are available at: http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?
filterType=none&filterByDID=99&sortByDID=3&sortOrder=ascending&itemID=CMS1186653

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AHRQ Study: Nurse-Led Care Benefits HF Patients

An AHRQ-funded study published in the August 15 issue of Annals of Internal Medicine indicates that patients with heart failure whose care was directed by nurse managers could perform everyday activities better and had fewer hospitalizations than patients who self-managed their own care.

Patients from four Harlem hospitals were included in the study; 127 were assigned to nurse management and 127 were assigned to usual care. Nurse managers counseled patients on the signs and symptoms of heart failure, benefits of a low-salt diet, and the importance of taking prescribed medications. They also arranged any medication changes and tests with the patients’ clinicians. Patients in the usual care group received only federal consumer guidelines for managing their condition but no other intervention.

At 12 months, nurse management patients had had fewer hospitalizations and better functioning than usual care patients. After 12 months, when the nurses were no longer counseling the patients, researchers found that the nurse-led patients’ functioning began decreasing at a rate similar to that of patients who had received no counseling at all.

“This nurse-led program made a significant difference in the everyday lives of heart failure patients. With the nurses’ guidance, patients were better able to perform routine activities and were hospitalized less,” said lead author Jane Sisk, PhD of Mount Sinai School of Medicine. “These results could help providers improve care for patients in other minority communities.”

An abstract of the article is available at: http://www.annals.org/cgi/content/abstract/145/4/273

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CDC Makes New Flu Materials Available

The Centers for Disease Control and Prevention (CDC) has released new posters, flyers, button, stickers, logos, and other educational materials for health care providers to use in promoting influenza vaccination during the 2006-2007 flu season.

The CDC Flu Gallery http://www.cdc.gov/flu/professionals/flugallery/index.htm contains Spanish and English materials in print and electronic versions as well as materials directed at senior citizens. Updates on vaccine supply, target populations, and recommendations will be posted as developments emerge during the flu season.

Quality Summit To Kick Off National Nursing Home Campaign

A one day Quality Summit will kick-off of a national, two-year, voluntary campaign to improve nursing home care. The campaign, “Advancing Excellence in America’s Nursing Homes” is a grassroots-focused effort that will build on and complement the work of existing quality initiatives including the Nursing Home Quality Initiative (NHQI), Quality First, and the culture change movement.

The invitation-only Quality Summit will address quality in today’s nursing homes, the need for public confidence in long-term care, the role of the caregiver workforce in quality improvement, and how the campaign will be implemented at the national and local levels. Former Senator Bob Kerrey and former Speaker of the House of Representatives Newt Gingrich, co-chairs of the National Commission for Quality Long-Term Care are expected to speak at the Summit.

Members of the coalition-based campaign include the Centers for Medicare & Medicaid Services, long-term care providers, health care practitioners and professionals, caregivers, Quality Improvement Organizations, other government agencies, and consumers. Participation in the campaign is available on three levels:

  • Providers – that agree to work on at least three of the campaign’s eight goals.
  • Consumers – that will help promote the campaign through public awareness about good quality nursing home care.
  • LANEs – Local Area Networks for Excellence, which serve as proactive leaders at the local level to coordinate nursing home improvement work and provide support and assistance to local participating providers.

The eight campaign goals include:

  1. Reducing high risk pressure ulcers;
  2. Reducing the use of daily physical restraints;
  3. Improving pain management for longer term nursing home residents;
  4. Improving pain management for short stay, post-acute nursing home residents;
  5. Establishing individual targets for improving quality;
  6. Assessing resident and family satisfaction with the quality of care;
  7. Increasing staff retention; and
  8. Improving consistent assignment of nursing home staff, so that residents regularly receive care from the same caregivers.

Participants are expected to select at least three of the eight measures to target for improvement. Data will be collected and the Campaign will make it public in an aggregated form to inform consumer decisions about nursing home care.

In addition to the QIOs, key stakeholders involved in the planning of the Campaign include: Alliance for Quality Nursing Home Care; American Association of Homes and Services for the Aging; American Association of Nurse Assessment Coordinators; American College of Health Care Administrators; American Health Care Association; American Medical Directors Association; Centers for Medicare & Medicaid Services (CMS), The Commonwealth Fund; The Evangelical Lutheran Good Samaritan Society; National Association of Health Care Assistants; National Citizens’ Coalition for Nursing Home Reform (NCCNHR); and the National Commission for Quality Long-Term Care. “We all share the very important goal of creating an environment where high quality nursing home care is an expectation for every American.” said departing CMS Administrator Mark McClellan, MD, PhD.

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