| November
25, 2003
For Immediate Release |
Contact:
Richard Deutsch
202-331-5790 Ext. 313 |
Medicare
Bill To Expand Quality Improvement Efforts
Washington,
D.C.—The Medicare bill passed by the Senate today assures that Quality
Improvement Organizations (QIOs) will take on additional responsibilities
and increase their efforts to improve the quality of care provided to
the nation’s seniors.
The final
Medicare bill instructs the Secretary of Health and Human Services to
use QIOs to begin conducting pharmacotherapy quality improvement projects
on a voluntary basis with providers, practitioners, as well as with the
prescription drug plan sponsors and Medicare Advantage plans created by
the legislation. The bill broadens the Medicare statute to require QIOs
to offer technical assistance for improving systems of care to all of
the new private plans created by the bill.
The bill
also authorizes the Secretary of HHS to contract with QIOs to lead new
Medicare demonstration projects that use information technology to improve
chronic disease management services for beneficiaries. In addition, the
bill offers financial incentives to encourage hospitals to regularly report
to the government on the quality of the care they provide under the new
system.
‘We
are grateful for the opportunity this legislation creates for QIOs to
improve the quality of outpatient pharmacotherapy for the elderly and
disabled,” said AHQA Executive Vice President David Schulke. “The
legislation will allow QIOs to follow up their work in hospitals to get
heart attack and heart failure patients started on life-saving medications
while they are still in the hospital. Now QIOs can help ensure these patients
fill and refill their prescriptions after discharge. We will closely monitor
implementation to see that the flow of drug utilization data from Medicare
Advantage plans and pharmaceutical benefits management firms is fast and
smooth.”
Adding
Safeguards to the New Drug Benefit
The legislation
requires QIOs to offer quality improvement assistance related to medication
therapy
provided by the new drug benefit. QIOs will work with plans and providers
to promote adoption of safe medication therapy and effective systems to
prevent errors and adverse events associated with the use of prescription
drugs.
Encouraging
Advances in Chronic Disease Management
The legislation
also creates a “care management performance” demonstration—
a three year pay-for-performance program designed to encourage physicians
to adopt and use health information technology and evidence-based outcomes
measures to improve continuity of care for chronically ill Medicare beneficiaries.
The bill
provides a statutory basis for forthcoming efforts by the Centers for
Medicare and Medicaid Services to help develop a framework and standards
for the use of information technology to improve the quality of care delivered
by physician practices, and it authorizes financial incentives to encourage
physicians to test and adopt such technology.
The bill
provides for QIOs or other contractors to offer technical assistance and
education to physicians enrolled in the demonstration program—to
assist physicians with adoption of health information technology, improve
their ability to meet practice standards, and boost capacity to implement
required clinical and outcome measures.
Providing
New Momentum for Quality Improvement in Hospitals
The bill also begins to apply pressure on hospitals to report data on
quality of care. In recent years ESRD facilities, nursing homes and home
health agencies have all begun to publicly report quality data. The legislation
calls for hospitals to begin submitting data on ten measures of quality
of care to the federal government next year or face cuts in Medicare payments.
“Public
reporting of quality data should have a similar effect on hospitals as
it has had on nursing homes and home health agencies,” noted Todd
Ketch, AHQA Vice President for Government Affairs, “As more and
more hospitals track and analyze their own data, and compare it to results
reported by their competitors, it will increase their incentive to work
with QIOs to improve quality of care.”
Under contract
to CMS, QIOs provide technical assistance on a voluntary basis to hospitals,
physicians, nursing homes, home health agencies, and Medicare + Choice
plans.
For More
Information on Quality Improvement Organizations: www.ahqa.org
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