Centers for Medicare & Medicaid Services (CMS) announces new, five-year contracts for regional Quality Improvement Organizations; nearly $1B in savings identified in previous cycle
Washington, D.C. — The American Health Quality Association (AHQA) offered its congratulations today to recipients of Quality Improvement Organization (QIO) contracts following an announcement by the Centers for Medicare & Medicaid Services (CMS). The contract awards are for organizations that will work directly with providers and communities on quality initiatives to improve health care provided to—and the overall health of—Medicare patients. Earlier this year, a CMS analysis found that QIOs facilitated improvements in care transitions that led to nearly $1 billion in savings during the previous three-year contract cycle.
The new contracts, which begin August 1, were awarded to 14 organizations nationwide. Contract recipients include:
- Atlantic Quality Improvement Network (District of Columbia, New York, South Carolina)
- Georgia Medical Care Foundation (Georgia, North Carolina)
- Great Plains Quality Innovation Network (Kansas, Nebraska, North Dakota, South Dakota)
- Health Services Advisory Group (Arizona, California, Florida, Ohio)
- Healthcentric Advisors (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)
- HealthInsight (Nevada, New Mexico, Oregon, Utah)
- Lake Superior QIN/Stratis Health (Michigan, Minnesota, Wisconsin)
- Mountain Pacific Quality Health Foundation (Alaska, Hawaii, Montana, Wyoming)
- Qsource (Alabama, Kentucky, Mississippi, Tennessee)
- Qualis (Idaho, Washington)
- Telligen (Colorado, Illinois, Iowa)
- TMF (Arkansas, Missouri, Oklahoma, Texas)
- VHQC (Maryland, Virginia)
- WVMI Quality Insights (Delaware, Louisiana, New Jersey, Pennsylvania, West Virginia)
* The Indiana, Puerto Rico, and Virgin Islands awards have not yet been determined.
“The contracting structure of the QIO Program has changed, but the focus of the QIOs remains the same—to drive quality improvement at the community level,” AHQA Executive Director Todd D. Ketch said. “For 30 years, the work of QIOs has been instrumental in a number of improvements that impact Medicare beneficiaries, most recently including reducing avoidable hospital admissions and readmissions, reducing pressure ulcers, and preventing potential adverse drug events. QIOs represent the ‘boots on the ground’ infrastructure for implementing HHS’ National Quality Strategy and other broad national health care improvement goals.”
Such goals include reducing health care-associated infections (HAIs), improving preventive care, reducing deaths from heart attack and stroke, and broadening the use of electronic health records. AHQA’s network of QIO professionals, from physicians to frontline nurses to communicators, helps provide quality improvement expertise every day in communities nationwide.
“I look forward to the QIOs’ continued efforts to help provide Medicare patients with the best, safest care possible no matter when or where they receive care,” said AHQA President Adrienne Mims, MD, MPH, who also serves as vice president and chief medical officer for Georgia-based Alliant GMCF. “While the goal remains improving care for Medicare beneficiaries, recent QIO successes point to the fact that this work positively impacts the care of every American who accesses our nation’s health care system.”
The contract recipients will be Quality Innovation Network QIOs, under a restructured QIO Program that separates the program’s case review work and quality improvement activities and extends contracts to five years from three. CMS has also moved to a regional contracting structure for the program.
In the years ahead, CMS will work with QIOs to focus on improving the way in which providers coordinate patient care across settings; reduce HAIs; improve care for high-incidence, chronic conditions like diabetes and heart disease; and more.
The work will build upon successes from the most recent three-year contract cycle (2011-2014), which included nearly $1 billion in cost savings nationally from the prevention of 95,000 hospitalizations and 27,000 hospital readmissions. QIOs also helped prevent 45,000 potential adverse drug events and prevent or heal nearly 3,400 pressure ulcers. Additionally, QIOs’ work with hospitals across the nation drove a 53 percent reduction in central line associated blood stream infections.