QIOs Gear Up for Remaking American Medicine
CMS Launches My Health.
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.
local listings for times:
One - “Silent Killer” Medical
Two - “First Do No Harm” Nosocomial
Three - “The Stealth Epidemic” Chronic
Four - “Hand in Hand” Patient-Caregiver
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
• Donald Berwick, MD, MPP, president and CEO, Institute for Healthcare
• 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
www.remakingamericanmedicine.org is expected to be available soon.
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
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.
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
October 1: Plans begin marketing.
Mid-October: 2007 Plan Data and enhanced Plan
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
“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
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
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:
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.
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
“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
More information on PHCD, including a fact sheet, solicitation, and
application are available at: http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?
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
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
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
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
- 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
The eight campaign goals include:
- Reducing high risk pressure ulcers;
- Reducing the use of daily physical
- Improving pain management for longer term nursing home
- Improving pain management for short stay, post-acute nursing
- Establishing individual targets for improving quality;
resident and family satisfaction with the quality of care;
staff retention; and
- Improving consistent assignment of nursing
home staff, so that residents regularly receive care from the same
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.