Author Archive for AHQA Staff

Medicare’s Quality Improvement Organization Program Facing Unprecedented Lapse

Washington, D.C.— The American Health Quality Association (AHQA) expresses deep concern about the immediate and long-term impacts of a recently announced lapse of up to four months in the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) program will have on the Medicare quality infrastructure.

“This is the most existential crisis that the QIN-QIO infrastructure has faced since its inception,” said Alison Teitelbaum, Executive Director of AHQA. “The loss of key personnel and subsequent dismantling of the Quality Improvement infrastructure is detrimental to Medicare beneficiaries and the providers that care for them. CMS has spent the last 30 years building up the most innovative and valued quality improvement system across the entire federal government, and it is now letting that program atrophy,” continued Teitelbaum.

The Centers for Medicare and Medicaid Services (CMS) announced that the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) program may lapse for as long as 4 months in a June 26 notice sent to quality contractors. Since July 17, the QIN-QIO program has ceased to provide quality improvement technical support to Medicare participating hospitals, doctors, and post-acute facilities.  CMS also ordered all referred casework from Medicare beneficiary quality complaints to cease as of July 17.

AHQA is deeply concerned about the immediate and long-term impacts this lapse is having on the Medicare quality infrastructure. In addition to the mandatory functions of the program terminating, there have been national layoffs and furloughs of QIN-QIO staff, including physicians, nurses, and health quality experts with decades of experience. As the lapse continues, those staff will be faced with hardships and the need to find alternative employment; representing a devastating migration of expertise out of the QIO sector.

The QIO program is a mandatory federal program with specific requirements to deliver technical assistance to Medicare providers for the purposes of quality improvement. QIOs are required to be independent and impartial so they can work as a trusted partner across multiple settings of care. In the last statement of work, QIOs have made incredible progress to improve the health status of communities through direct beneficiary engagement, reduced hospital readmissions, improved nursing home care, helped physicians navigate the new Quality Payment Program, and saved the Medicare Trust Funds billions of dollars.

Congress modernized the QIO program in 2011 to provide CMS with requested changes to the program to make the program easier to administer; most notably reducing the number of QIO contracts through the regionalization of the previously state-based program. During this reform, the AHQA was assured that the savings would drive more resources to fieldwork and make the program more stable. However, the QIN-QIOs received less than 19% of overall QIO program expenditures in the first post-reform statement of work and are facing an unprecedented lapse in the first post-reform rebid. “Following the 2011 reform of the program, we hoped that we would see increased transparency and funding for this program. Unfortunately, we have seen neither and instead are witnessing one of the first complete shutdowns of the program since its inception,” said Teitelbaum.

AHQA is asking CMS to prioritize the award of the next 5-year statement of work for the QIN-QIO program, and to execute an immediate no-cost extension of the last statement of work so that the mandatory functions of the program supporting Medicare beneficiaries and providers can re-commence immediately.

AHQA represents the national network of QIOs working to advance the quality of health care for America’s Medicare beneficiaries. In every state, QIOs work hand-in-hand with local providers, consumers, and stakeholders across the continuum of care—including in hospitals—to help ensure that when our nation’s Medicare beneficiaries receive medical care, regardless of the setting, it’s the best and safest care possible.

 

 

 

AHQA Statement On The Signing Of The SUPPORT For Patients And Communities Act

“The signing of H.R. 6, the SUPPORT for Patients and Communities Act, represents a significant and positive step forward to combating the nation’s opioid crisis. We at the American Health Quality Association (AHQA) applaud this bill for providing the path and funds critically necessary for our nation’s premier quality improvement professionals to work with providers to reduce unnecessary opioid prescriptions.

This bipartisan law includes the REACH OUT ACT of 2018, originally introduced by Representative Brian Fitzpatrick (R-PA 8) and co-sponsored by Representatives Mike Thompson (D-CA 5), Greg Walden (R-OR 2), Michael Burgess (R-TX 26), Marsha Blackburn (R-TN 7), and Elliot Engel (D-NY 16), is an evidence-based, provider outreach program aimed at educating outlier prescribers with the explicit goal of achieving demonstrable reductions in opioid prescribing. Variants of this healthcare provider technical assistance program were developed and piloted by several Quality Innovation Network – Quality Improvement Organization (QIN-QIO)s around the country as Special Innovation Projects (SIP)s through the Centers for Medicare & Medicaid Services (CMS) with excellent results. Projects funded through the SIP program are ‘interventions that are ripe for scale and spread, as described by CMS.

Over a 30-year history, the QIOs have demonstrated a unique ability to work locally with providers to improve quality on a national level. We are gratified that this legislation will secure a broader impact through the provision of critical technical assistance aimed at reducing inappropriate opioid utilization throughout the U.S. and the territories. We believe that leveraging the QIOs for this critically important effort is a cost-effective and efficient solution to offering provider technical assistance in communities across the country.

As the leading organization representing QIN-QIO’s AHQA would like to extend our deepest gratitude to the following representatives for their efforts in securing passage of this bill: Brian Fitzpatrick (R-PA 8) Mike Thompson (D-CA 5), Greg Walden (R-OR 2), Michael Burgess (R-TX 26), Marsha Blackburn (R-TN 7), and Elliot Engel (D-NY 16). Despite the polarization in Washington, these members moved one step forward to solving this crisis that is tearing through our country and families. Due to their hard work and dedication, Medicare’s leading “boots on the ground” will be deployed to help combat the opioid crisis.

Specifically, this will empower qualified, independent organizations like Medicare Quality Improvement Organizations (QIOs) to redouble their efforts to newly signed bill assures increased, long-term commitment to addressing the nation’s growing opioid crisis.”

American Health Quality Association’s (AHQA) QIN-QIOs are Pivotal in Reducing Costs for Medicare and Improving Health Quality, 2017 CMS Progress Report Reveals

McLean, VA:  In a report released earlier this month, 2017 QIO Program Progress Report, the Centers for Medicare & Medicaid Services (CMS) revealed Quality Improvement Networks-Quality Improvement Organizations (QIN-QIOs) to be the most effective “Boots on the Ground” in the ongoing efforts to reduce costs for Medicare and improve health quality for millions of Medicare beneficiaries across the United States. The successful community- and provider-level work carried out by the QIN-QIOs in 2017, guided by the educational and advocacy support of the American Health Quality Association (AHQA), further cements the QIO Program as the preeminent Medicare Quality Improvement Program. CMS’s report detailed numerous meaningful and impactful achievements of QIN-QIOs  in 2017; highlights include the following:

  • More than 4.7 million recruited Medicare beneficiaries impacted through education/outreach
  • More than 312,550 pneumonia immunizations administered
  • 600,000 flu immunizations administered
  • 2.3 million beneficiaries at high risk for an adverse drug event (ADE) were screened
  • 1.4 million medication-related adverse outcomes were identified for potential ADEs
  • The QIN-QIOS recruited more than 12,200 nursing homes (more than 78% of all nursing homes in the United States) to join their quality improvement efforts
  • 75.7% of tobacco users provided with cessation counseling, exceeding the 45% target
  • For every dollar spent on the program, the QIN-QIO program saved the U.S. government five dollars.

“These findings tell us what we already know. The QIN-QIO Program is the most effective and cost-efficient quality improvement infrastructure within CMS,” said Alison Teitelbaum, executive director of the American Health Quality Association (AHQA), the leading QIN-QIO trade association “When the QIN-QIO program was restructured in 2014, part of the aim of that effort was to streamline efficiencies so that best practices and innovations could be more easily spread across the country. It’s clear that this program is far exceeding those expectations. We’re confident that the QIN-QIO program, established by Congress and managed by CMS, can provide an even greater return, both financially and to the health of our nation, by being leveraged to its full statutory potential as we move forward,” continued Teitelbaum. “It’s clear that the QIN-QIOs both help reduce costs through readmission and adverse medical event prevention and improve the quality of care for all beneficiaries.”

“The numbers here are definitive in what they inform us—that the QIN-QIOs continue to significantly improve the health and wellbeing of Medicare patients nationwide. Our work and progress are a testament to our ability to partner with providers and healthcare facilities across the entire continuum of care,” said Dr. Russell Kohl, president of AHQA. “No other quality improvement program in the country supports providers along the path that the patient travels through care—from inpatient setting to outpatient setting and beyond. That’s one of the hallmark characteristics of this program and of the QIN-QIOs themselves.”

The 14 QIN-QIOs work with providers, community partners, and Medicare beneficiaries to improve patient safety, reduce health care disparities, and multiple other data-driven quality improvement measures. Separately, two Beneficiary and Family-Centered Care-QIOs (BFCC-QIOs) address all beneficiary concerns, quality of care reviews, and appeals under the QIO Program. This report shows the achievements that were made across the various clinical focus areas that were laid out by CMS for the QIO Program in 2017. The QIN-QIOs conduct these improvements under the direction of five-year contracts known as “Scopes of Work,” (SoW); the current SoW will conclude in 2019.

To read the full 2017 QIO Progress Report, visit https://progressreport.qioprogram.org/#section-1. For more information about AQHA, contact info@ahqa.org.

Since 1984 the American Health Quality Association (AHQA) has represented Quality Improvement Organizations (QIOs) and other professionals working to improve health care quality and patient safety. AHQA is an educational, not-for-profit national membership association dedicated to promoting and facilitating fundamental change that improves the quality of health care in America. 

Reflections From the 2018 AHQA Quality Summit

On July 9-10, The American Health Quality Association (AHQA) convened national partners working to improve healthcare quality in Baltimore, MD for the 2018 AHQA Quality Summit. Honored to have attended as a James Q. Cannon Fellow, I spent these two days learning from expert speakers and peers about strategies for continued healthcare quality improvement through community awareness, innovation and collaboration.

Being a first-time guest to Baltimore I wandered nearby Inner Harbor with our group on Sunday evening and—in true tourist fashion—gaped at the Maryland Science Center, the World Trade Center Institute Baltimore, the USS Constellation, Camden Yards and much more. I also tried the much-acclaimed crab cakes which, for the record, absolutely live up to the hype.

Over the next two days I made countless connections between my work as part of Lake Superior Quality Innovation Network (QIN)(link is external) in Michigan and the impactful work being done by fellow attendees and presenters nationwide. Below are takeaways from sessions I attended including new perspectives to apply to my work as a member of Lake Superior QIN. As these summaries are somewhat brief, I encourage you to visit the 2018 AHQA Quality Summit webpage for a complete list of sessions  and presentation slides.

The Science of Burnout and Well-being in Healthcare: How Other People Matter, Kathryn C. Adair, Ph.D.

Dr. Adair, social psychologist with the Duke Patient Safety Center(link is external), began the Summit by discussing the science of burnout and wellbeing in healthcare. With many demands and limited time facing healthcare providers in our current system, this topic was extremely timely and inspired conversation throughout the rest of the Summit. Study data presented during this session drove home the quiet ubiquity of healthcare provider burnout, specifically in:

  • Critical care nurses: half are emotionally exhausted, two out of three have difficulty sleeping, and one out of four are clinically depressed.
  • Surgeons: 8.9 percent reported making a major medical error in the previous three months (reporting an error had significant correlations with all three domains of burnout).
  • Medical students: half are burned out, nearly half report excessive fatigue and 10% percent have suicidal ideation (compared to 3.7 percent in the general population).

In addition to the impact of burnout Dr. Adair also discussed environmental correlates that act as buffers, or “burnout band aids,” including (but not limited to) social support, a positive learning environment, satisfaction in conversation with others and positive working relationships. To address and prevent healthcare provider burnout—as well as strengthen workforce resilience—Dr. Adair recommended implementing both institutional and personal interventions.

Personal reflections:

  • “Focus determines your reality” and “perceptions are influenced by how you feel” – our internal environments influence what we contribute to and take from daily interactions.
  • As Quality Innovation Network-Quality Improvement Organization (QIN-QIO) staff, we are in a prime position to reduce healthcare provider burnout by aligning initiatives with clients’ priorities including quality reporting programs, unique community needs and payment mechanisms.

Takeaways for my work as part of Lake Superior QIN:

  • Support provider and partner resilience to prevent burnout and promote project sustainability
    • Continue to provide technical assistance (TA) that accounts for and optimizes workflow.
    • Recognize success in fostering teamwork and positive working environments.
    • Encourage “positive rounding” in internal and client meetings/huddles to recognize what’s going well and individual/organizational successes.

Find strategies, slides and references from this presentation here.


Driving Change and Moving Toward the Future: Looking Ahead for the QIO Program, Jeneen Iwugo, MPA and Paul McGann, M.D.

Jeneen Iwugo, MPA and Paul McGann, M.D. from the Quality Improvement & Innovation Group in the Center for Clinical Standards and Quality at CMS discussed results achieved from the current 11thScope of Work to date and future directions for the QIO program(link is external).

National progress made so far in the 11th Scope of Work includes:

  • 350,000 fewer patient harms, 8,000 lives saved and more than 2.9 billion in cost savings.
  • 18.7 percent reduction in antipsychotic medication use in residents living in long-term care facilities.
  • 91 percent of MIPS eligible clinicians, 98 percent of accountable care organizations and 94 percent of MIPS eligible clinicians in rural practices submitted data for the 2017 performance year.
  • Prevented 46,000 hospital readmissions and contributed to $600 in cost savings throughout 387 communities.
  • Educated 5,300 providers and 48,662 Medicare beneficiaries completing diabetes self-management education.

With more to come!

Potential focus areas for the next Scope of Work were shared including workforce burden reduction, improving behavioral health including opioid abuse, improving chronic disease management (cardiovascular, diabetes, CKD-ESRD), increasing patient safety, increasing quality of care transitions and long-term care. Proposed focus areas resulted from public input and CMS’ Agency priorities and would incorporate rural health, vulnerable populations and patient and family engagement as cross-cutting priorities.

Find more QIN-QIO programming results, future directions and slides from this presentation here.

 

Reducing Provider Burden with an Integrated Outpatient Services Approach, Sharon Donnelly, M.S. and Sharon Phelps, R.N., BSN, CPHIMS

Sharon Phelps from Mountain-Pacific Quality Health Foundation(link is external) and Sharon Donnelly from Qualis Health(link is external)/HealthInsight(link is external) described their many partnerships, collaborations and considerations in working with providers on their QIN-QIO task work. A two-pronged approach presented consistent focus on reducing burden for providers and internal staff, including:

Reducing Provider Burden

Reducing Internal Burden

  • Bringing solutions and value.
  • Using resources across contracts.
  • Focusing on unique needs, challenges and goals of clinics.
  • Redesigning documentation and reporting processes.
  • Providing primary contacts for resources, assistance and support.
  • Regional approach to developing and providing TA (i.e., educational offerings and tools).
  • Aligning disparate programs, measures and initiatives into a cohesive program.

 

 

Programming for outpatient providers is streamlined by grouping interventions into four core categories—advance care planning, annual wellness visit, transitional care management and chronic care management—within a framework of current and new payment mechanisms. The session described work designs that incorporate collaboration, alignment, big picture thinking and technology solutions that successfully break down programming silos and build on clients’ priorities and goals.

Takeaways for my work as part of Lake Superior QIN:

  • Continue to regionalize task TA to promote consistency and meaningful evaluation.
  • Support burden reduction by optimizing health information technology in practices and empowering providers to use available EHR functionalities to input and act on data.

Find more on this integrated services approach and slides from this presentation here.

 

A QIN-QIO Collaborates with Academia: Engaging Small Practices in Blood Pressure Control, Joanne Vanterpool, MBA and Susan Hollander, MPH, CPHQ

During this session, Susan and Joanne presented their work on Project Implementing Million Hearts for Provider and Community Transformation (IMPACT).(link is external) Started in 2014, this initiative centers on Million Hearts®(link is external) goals with a focus on improving blood pressure control and cardiovascular outcomes in the South Asian community cared for in primary care settings across New York City. Project partners provide TA and subject matter expertise to targeted practices, including:

  • Evaluating use of community health workers (CHWs) and EHR functionalities and interventions.
  • Testing and implementing CHW and EHR-based tools targeting Million Hearts® goals.
  • Developing and implementing culturally tailored provider training programs to empower direct care staff to improve hypertension control.

Personal reflections:

  • A theme continues – Joanne and Susan described an approach to programming that aligns initiatives and incentive programs and supports optimizing practices’ resources (improving patient care and outcomes + minimizing burden).

Takeaways for my work as part of Lake Superior QIN:

  • Utilize lean approaches to drill down to root causes of providers’ challenges in caring for patients with chronic conditions.
    • Example: is a practice’s percentage of patients with controlled blood pressure (BP) (NQF 0018) persistently low?
      • Asking The Five Whys(link is external) may reveal that inconsistent staff technique for manual BP measurement may be overestimating patients’ BP and assistance is needed to facilitate competency training.
      • Example based on findings from a root cause analysis in Michigan (before my time) that contributed to regional collaboration on Lake Superior QIN’s Hypertension Management Toolkit(link is external).

Find more on programming approach and Project IMPACT here.

 

Overarching theme – the opioid epidemic

In addition to burden reduction, the opioid epidemic(link is external) was also a common theme throughout multiple sessions, including:

These sessions issued a clear call to action to attendees to continue national work with healthcare providers on prevention efforts and rapid response projects to support quality care and patient safety.

Connecting and collaborating

In addition to presentations highlighting quality improvement program successes, I attended a brainstorming breakout session called “Collaborate & Solve!”, facilitated by AHQA Executive Director, Alison Teitelbaum, M.S., MPH, CAE. During this session, we identified common challenges in our work and split up into small groups to discuss lessons learned. My group explored work silos both within our organizations and with stakeholders:

  • The issue: groups don’t always see value in collaboration (possibly due to organization cultures, fear of change, etc.).
  • Brainstorming – what we have seen work for silo breakdown:
    • Researching the landscape and taking advantage of existing groups, advisory boards and coalitions (statewide and regional).
    • Listening to partner and stakeholder experiences (learn vs. reinventing the wheel).
    • Coordinating so that joint efforts become comfortable and keeping communication open (regular touch base calls) about what is going on and continued interest in partnership.
    • Uniting under the understanding that we can’t reach everyone we want to reach without partnering.

One point presented by one of my fellow brainstormers stuck with me both personally and for my work as part of Lake Superior QIN: “It’s amazing what you can accomplish when you don’t care who gets the credit” – Harry Truman.

Find additional small group topics and discussion notes here.

Reflections and thanks

As I reflect on my first experience attending the AHQA Quality Summit, I’m left with broadened perspectives and a great sense of purpose and gratitude. I want to express sincere thanks first to the AHQA Board of Directors and all involved in the development of the James Q. Cannon Memorial Scholarship for the opportunity to attend this year’s event and for investing in early career professionals. Thank you to all those involved in the planning and successful execution of the 2018 Quality Summit as well as the speakers who dedicated their time and expertise to make this a truly educational and engaging event. Finally, thank you to my fellow attendees for inspiring me to a wider perspective on our work and its continued importance – I hope we meet again at future summits and out in the field with our boots on the ground, continuing to support quality healthcare nationwide.

Quality Conference was a great time for healthcare professionals and leaders to collaborate and learn

The AHQA 2018 Quality Conference was a great time for healthcare professionals and leaders to collaborate and learn about the issues most pressing in healthcare today.

The conference opened up with K. Carrie Adair, from Duke University who presented on The Science of Burnout and Well-being in Healthcare: How Other People Matter. This was a great way to open up the conference because burnout is applicable to everyone, in every field, not just healthcare. Adair captured the audience by presenting on the meaning of burn out and how humans are just generally tired. Most notably, she focused in on nurses in healthcare and shared some alarming statistics on nursing burnout. Sure, we all know the healthcare industry is full of professionals who are burning out and overworked, but when you put it in a graph it is distressing. In critical care in particular, half of the nurses are “emotionally burnt out” 1 out of 3 have trouble sleeping, and 1 out of 4 are clinically depressed (Sexton, et. Al. (2009).Palliative Care). She shared some interesting studies paired with crowd participation on how humans are trained to see the negative. It was eye opening, and definitely a great way to start a conference, Bravo!

The rest of the two days were filled with breakout sessions on various hot topics in the healthcare industry. Of course, there was a fair share of presentations and breakout sessions on opioids. One of the biggest topics of the healthcare field today.

Sara Derr, PharmD and Meg Nugent, MHA, RN presented on behalf of the Iowa Healthcare Collaborative on the IHC Opioid Guardianship Project. Another stand out for me in opioids, was Amanda Ryan, PharmD, BCGP from Atom Alliance’s presentation on Opioid Performance Improvement Project in Nursing Homes: Utilizing a Virtual Collaborative to Drive Results.

The AHQA Quality Conference was a two-day event filled with many healthcare quality improvement professionals sharing ideas, collaborating and discussing the future of healthcare. Alongside some Medicaid and CMS representatives giving us the insight on the future of CMS’ Quality Improvement initiatives, timelines and expected outcomes. Jeneen Iwugo and Paul McGann, MD presented on Driving Change and Moving Toward the Future: Looking Ahead for the QIO ProgramBeing part of a QIN-QIO myself, I was most interested in this presentation. Iwugo and McGann thanked us for our hard work, commitment and for improving the quality, safety, and delivery of care to Medicare beneficiaries. They talked about the future of our work, and the bold aims they plan to set. Well, we look forward to seeing those aims, and discussing our success at them at the AHQA Quality Conference in 2019!

Improving the quality of healthcare is meaningful, important, life-changing work

Improving the quality of healthcare is meaningful, important, life-changing work, but it can also be very challenging. As quality improvement professionals, supporting one another through peer-to-peer sharing and collaborative relationships is critical to success. It takes all of us with unique perspectives and expertise to facilitate the changes needed to continue making healthcare better.

AQHA is a key piece of the professional support needed to change healthcare in America, and the annual AHQA Quality Summit provides a place to receive and share that support with others working to improve healthcare quality. I was honored to attend the 2018 Quality Summit in Baltimore as a recipient of a James Q. Cannon Memorial Scholarship. At the summit I met and exchanged ideas with quality improvement professionals from around the nation. Some were people I have spoken to on the phone many times, and putting a face to the name strengthened those relationships. Others I had never met, and we all left with a larger and stronger network of support. Attendees also had the opportunity to interact frequently with AHQA staff to share successes and request support with challenges in quality improvement work.

Peer-to-peer sharing was available in the many breakout sessions, with topics ranging from reducing provider burden, to patient and family engagement, and medication safety. Most relevant to my work as a pharmacist were the sessions on opioid safety. Hearing from QIN-QIOs and others on their successful work in this area is now helping to shape our opioid work at the atom Alliance QIN.

As we near the end of the 11th SOW, it was helpful to hear from Dr. Paul McGann and Jeneen Iwugo from CMS in a plenary session on the future of the QIO program. Another plenary focused on workplace resiliency and the importance of showing gratitude to reduce burnout. As all of us work together to change lives for the better through higher quality healthcare, these skills will be key for us to practice and share with others.

I encourage you to attend the Quality Summit in 2019. As QIN-QIOs transition into the next scope of work, our capacity to change healthcare and the corresponding challenges will continue to increase. The Quality Summit provides the resources, relationships, and support we need to bring patients and communities the healthcare they deserve.

Members Elect New Officers and Director at Annual Member Meeting

McLean, VA: At the recent annual membership meeting, the members of the American Health Quality Association (AHQA) elected the Officers and Directors for the 2018 – 2019 term. Dr. Russell Kohl, chief medical officer at TMF Health Quality Institute, was elected President. TMF is the Medicare Quality Innovation Network-Quality Innovation Organization (QIN-QIO) responsible for health care quality improvement in Arkansas, Missouri, Oklahoma, Texas and Puerto Rico. The QIN-QIO program operates in five year contracts from the Centers for Medicare & Medicaid Services (CMS) and AHQA is the leading trade association for the QIN-QIO program.

As chief medical officer at TMF, Dr. Kohl  leads its Innovation and Analytics Team, and serves as a subject matter expert on two of TMF’s federally contracted tasks to assist physicians with the Medicare Quality Payment Program and the Comprehensive Primary Care Plus Initiative.

He is a graduate of the University of Oklahoma College of Medicine, where he also completed his residency and remains on the adjunct faculty with their Rural Residency Training Program. He is a family physician who strives to identify what is truly important to and for patients, identifying how to measure those things and improve them in collaboration with health professionals from solo primary care offices to academic health care systems.

In addition, Dr. Kohl is a lieutenant colonel and senior flight surgeon in the Missouri Air National Guard, having served in both Iraq and Afghanistan.

“I’m excited to step into this role. One of my top priorities as President of AHQA is to help the QIN-QIO Program receive the recognition for its unique role in improving the quality of care for Medicare beneficiaries and advocating for our members to both Congress and the administration,” said Dr. Kohl.

Also elected at the meeting were Dr. Sven Berg (CEO of Quality Insights) as President-elect and John Keimig (CEO of Healthcentric Advisors) as Treasurer. Marie Dunn (Vice President, Quality & Safety Initiatives at Quails Health) was newly elected to the Board of Directors.

Since 1984 the American Health Quality Association (AHQA) has represented Quality Improvement Organizations (QIOs) and other professionals working to improve health care quality and patient safety. AHQA is an educational, not-for-profit national membership association dedicated to promoting and facilitating fundamental change that improves the quality of health care in America.

AHQA Applauds Passage of the REACH OUT Act to Address Opioid Crisis

Yesterday the U.S. House of Representatives passed H.R. 5796, the REACH OUT Act by unanimous consent. This bipartisan legislation introduced by Congressmen Brian Fitzpatrick (R-PA 8), Mike Thompson (D-CA 5), and Carlos Curbelo (R-FL 26), accesses the nation’s Quality Innovation Network-Quality Improvement Organization (QIN-QIO) infrastructure in order to offer timely resources to address the opioid epidemic.

Specifically this legislation sets aside $75 million in funding in FY19 for grants to QIOs to provide technical assistance to high opioid prescribers. QIN-QIOs operate in all U.S. states and most territories and act as a clinical quality field force committed to providing technical support that will reduce the frequency of opioid prescribing at the local level.

“This bill enables the nation’s premier quality improvement network to help stem the tide of the opioid epidemic through education and outreach, which are important tools to improving health quality. Too often the discussion around opioids is about treatment and policing, and not enough about prevention. This bill will give our public health infrastructure another tool to fix the opioid epidemic that is destroying communities and lives throughout the country,” said Alison Teitelbaum, Executive Director of the American Health Quality Association, the leading trade association for the QIN-QIO program that has been advocating for the REACH OUT Act.  

Opioids now account for an astonishing 39 million Medicare Part D claims each year, and CDC data indicate that 90,000 patients in the U.S. are currently at serious risk of harm from opioids. Medical professionals prescribing opioids are key stakeholders to help reduce, and ultimately prevent, inappropriate opioid prescriptions. The REACH OUT Act empowers QIOs to educate outlier prescribers regarding best practices for opioid and non-opioid pain management therapies, with the explicit goal of achieving demonstrable reductions in opioid prescribing. The legislation will improve the quality of health care in the country and keep unnecessary opioid prescriptions out of circulation.

Since 1984 the American Health Quality Association (AHQA) has represented Quality Improvement Organizations (QIOs) and other professionals working to improve health care quality and patient safety. AHQA is an educational, not-for-profit national membership association dedicated to promoting and facilitating fundamental change that improves the quality of health care in America.

AHQA President Quoted in Press Release by Rep. Brian Fitzpatrick (R-PA 8)

AHQA President, Dr. Clare Bradley, was quoted in a press release issued by the office of Representative Brian Fitzpatrick (R-PA 8) in support of the REACH OUT Act (H.R. 5796). The REACH OUT Act, will direct CMS to work with entities including QIO’s to engage in outreach with prescribers identified as clinical outliers share best practices to evaluate their prescribing behavior. 

Fitzpatrick, Curbelo, Thompson Opioid Bill Heads to House Floor

June 8, 2018

Press Release

WASHINGTON, DC – Congressmen Brian Fitzpatrick (R-PA), Carlos Curbelo (R-FL), and Mike Thompson (D-CA) authored a bipartisan bill to help medical professionals implement best practices for prescribing opioids. Their REACH OUT Act unanimously passed the Energy and Commerce Committee and will be considered by the full House this month.

The Responsible Education Achieves Care and Healthy Outcomes for Users’ Treatment (REACH OUT), H.R. 5796, will direct the Centers for Medicare and Medicaid Services (CMS) to work with eligible entities, including Quality Improvement Organizations, to engage in outreach with prescribers identified as clinical outliers to share best practices to evaluate their prescribing behavior.

The legislation would build on the lessons learned from CMS special innovation projects by spreading best practices for preventing prescription abuse, providing outreach and education about non-opioid pain management, and reducing the number of opioids prescribed by outlier prescribers. An outlier prescriber is identified by the Secretary of Health and Human Services, in consultation with professional stakeholders, as one who prescribes an excessive number of opioids as compared to other prescribers in their medical specialty and geographic area. 

“As an EMT and vice-chair of the Bipartisan Heroin Task Force, I’m working each day to find new ways to tackle the opioid epidemic head on. We need to ensure that our medical professionals possess the latest best practices for preventing prescription abuse, including non-opioid pain management,” said Rep. Fitzpatrick. “By facilitating outreach to outlier opioid prescribers, the REACH OUT Act seeks to educate physicians on their prescribing behaviors without limiting their ability to deliver patient care. It will be an effective step towards reducing the amount of unnecessary prescription opioids in communities across the nation.”

“The opioid crisis is not just a South Florida issue, but a national epidemic that has devastated communities across the country,”said Rep. Carlos Curbelo. “I was proud to co-sponsor the REACH OUT Act and ensure we are facilitating necessary outreach and education about non-opioid alternatives for pain management to reduce the number of opioids being prescribed.”

“An important piece of combatting the opioid epidemic is giving providers the tools they need to prescribe opioids safely. By educating providers who’ve been identified as excessive prescribers of opioids on best practices or pain management alternatives, we can help them improve care delivery without micromanaging their prescribing practices,” said Rep. Mike Thompson. “That’s why I coauthored the Reach Out Act to give doctors technical assistance to take these steps to reduce opioid prescription in the first place. Our work to fight this crisis must continue so we can promote access to treatment to help the thousands of Americans still suffering.”

The REACH OUT Act received the endorsement of the American Health Quality Association.

“The American Health Quality Association applauds Congressman Fitzpatrick’s leadership fighting for essential resources to combat the opioid epidemic. Opioids now account for an astonishing 39 million Medicare Part D claims each year and CDC data indicates that 90,000 patients in the U.S. are currently at serious risk of harm from opioids. Medical professionals prescribing opioids are key stakeholders to help reduce, and ultimately prevent, inappropriate opioid prescriptions,” said Clare Bradley MD, MPH, President of the American Health Quality Association. “The REACH OUT Act establishes a national program to provide efficient, low-cost, high-value interventions to help prescribers implement best practices for prescribing opioids. This legislation will improve the quality of health care in the country and keep unnecessary opioid prescriptions out of circulation.”

Voiding Hospital Readmissions Saved Medicare Almost $400 Million through the QIN-QIO Program

Actions of American Health Quality Association’s Members Helped Reduce Medicare Spending

Mclean, ViA: Since 2014, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) Program has saved an estimated $400 million in Medicare spending by avoiding hospital readmissions and improving quality of care throughout all healthcare settings, which the American Health Quality Association (AHQA) is pleased to announce. The findings were first announced at the February 2018 Centers for Medicare & Medicaid Quality Conference. These savings represent more than half of the program’s total allocated fund of $717 million.

The savings are a result of work taking place in 387 communities across all 50 states and U.S. territories in which the QIN-QIO Program has partnered. These communities represent 66.2 percent of all Medicare beneficiaries. 

“We were thrilled to see the enormity of these savings, but not surprised. Research shows that improving the quality of patient care helps reduce costs over time. These savings further demonstrate that, as well as the strength, breadth, and impact of the QIN-QIO program,” said Alison Teitelbaum, executive director of the American Health Quality Association (AHQA), the leading trade association for the QIN-QIO Program. 

Reducing readmissions is just one of 12 tasks QIN-QIOs are currently addressing under contract to CMS during its five-year Quality Improvement Program 11th Statement of Work, ending in 2019. As Medicare’s largest quality improvement infrastructure, QIN-QIOs work with healthcare providers and communities across the country on data-driven interventions and initiatives to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries.

“What’s remarkable about the QIN-QIO Program is that our work is not limited to just hospitals. Our members tailor health quality improvements across every care setting and in every state. Whether you’re a rural or urban doctor our QIOs are there, meeting you where you are, creating resources and information that are tailored to help you improve the quality of care you provide to your patients, while simultaneously reducing costs to Medicare,” said Clare Bradley, MD MPH, president of AHQA. 

Created 30 years ago by an act of Congress, the QIN-QIO Program has shown itself to be one of the federal government’s most effective quality improvement infrastructures. 

“In an environment where everyone is focused on reducing Medicare spending, our members are doing just that, while at the same time increasing the quality of care for beneficiaries,” said Teitelbaum.

Since 1984 the American Health Quality Association (AHQA) has represented Quality Improvement Organizations (QIOs) and other professionals working to improve health care quality and patient safety. AHQA is an educational, not-for-profit national membership association dedicated to promoting and facilitating fundamental change that improves the quality of health care in America.