Author Archive for AHQA Staff – Page 2

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.

San Antonio Practice Uses Medicare Wellness Visits to Improve Behavioral Health Screening Rates


The Centers for Medicare & Medicaid Services (CMS) offers two types of visits covered by Medicare: The Welcome to Medicare preventive visit and an Annual Wellness Visit. During these visits, primary care physicians develop and update a personalized prevention health plan based on a patient’s health and risk factors determined from a Health Risk Assessment (HRA). As part of the HRA, patients and providers review various behavioral health risks, including mental health and alcohol use.1

The TMF Quality Innovation Network Quality Improvement Organization (QIN-QIO), under contract with CMS, offers assistance to physicians in Arkansas, Missouri, Oklahoma, Texas and Puerto Rico with screening for depression and alcohol use disorder under its Behavioral Health initiative. Yolanda Marcos, MD, a primary care physician specializing in Internal Medicine at Marcos Medical Care in San Antonio, Texas, is a participant in the Behavioral Health initiative. Dr. Marcos, her nurses and her medical assistants received technical assistance from a TMF QIN-QIO consultant to become familiar with alcohol and depression screening. Dr. Marcos’ patient visits are spread out throughout the year, allowing her and her team time to conduct a thorough physical that includes screening for behavioral health. Completing the Medicare Annual Wellness Visit has helped the practice do a better job at capturing depression and alcohol-related issues.

Dr. Marcos attests, “[TMF QIN-QIO] giving validity for these screenings and education to the staff was extremely helpful.” Despite her staff already being familiar with screening tools, working with an outside organization like the TMF QIN-QIO only validated the need to screen these patients to effectively provide quality care.

Dr. Marcos also contributed her high screening rates to an application called Phreesia, which sends an email to patients with a set of questions to be answered before their visit. If the patient does not fill out the questions ahead of time, front desk staff gives them a tablet to use in the waiting room. The questions the patients receive are tailored to their specific type of appointment. Patients that are scheduled for their Medicare Annual Wellness Visit will receive the depression and alcohol screening as part of this process, and the questionnaire is automatically uploaded to patient charts upon completion. The medical assistant then reviews the score and enters it into the visit notes for the provider to review with the patients. This workflow helps patients complete the screening questions efficiently, leaving more time for other topics during the visit.

Dr. Marcos has made it her goal to screen patients consistently. Completing the screening is one small part of the process, so she has her team continually assess and modify the workflow to increase the number of screenings across patient populations. Dr. Marcos takes the prevalence of behavioral health disorders seriously, so she aims to improve the quality of care she delivers, regardless if patients are visiting for a Medicare Annual Wellness Visit or not, and address conditions before they escalate. Perhaps the most positive outcome Dr. Marcos has seen from her screenings is that patients have to take charge in order to complete their own screeners. Since Marcos Medical Care has embraced these behavioral health screenings within the practice, the practice has maximized treating the whole health needs of their patients, recognizing that behavioral health and physical health are interrelated.

The graphs below demonstrate the screening rates over two years of Marcos Medical Care’s 3,506 patients among all payer types, including self-pay. Dr. Marcos implemented Phreesia around October of 2016.

AHQA Members Excellence Prominently Featured at Annual CMS Quality Conference

The Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) were prominently featured for their hard work and innovation at the recent Centers for Medicare & Medicaid Services’ (CMS) Quality Conference. This unique, annual event brings healthcare quality improvement professionals together with administration leaders to collaborate, share, and build upon their work.

While making up only a portion of the estimated 2,600 attendees, the QIN-QIOs played a comparatively outsized role in their contributions by being featured in many panels and standing room-only presentations.

The QIN-QIOs’ high profile in the conference was a further demonstration of the impact that they have nationwide in putting patients over paperwork (one of the themes of this year’s conference) and in improving the quality of healthcare for Medicare beneficiaries.

“Each year the QIN-QIOs deploy new and innovative approaches that successfully deliver high-impact quality improvement for Medicare patients,” said Alison Teitelbaum, executive director of AHQA. “Through these tailored interventions, the QIN-QIO Program contributes to hundreds of millions of dollars of savings for the government each year while, at the same time, reduces burdens on providers and continually puts patients first,” continued Teitelbaum.

During the Quality Conference, representatives from the QIN-QIO community also leveraged their expertise to identify new and emerging health issues, as well as scalable innovative pilot initiatives, that could be included in future work.

Opioid misuse and behavioral health concerns dominated these conversations, with many QIN-QIOs showcasing preliminary results from recently piloted innovative regional projects. These programs will be further highlighted at AHQA’s Quality Summit, taking place July 9-10, 2018 in Baltimore, MD.

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. 

District of Columbia’s Nursing Home Quality Care Collaborative: Improving Resident’s Quality of Life

Over one million Americans reside in the nation’s 15,800 nursing homes on any given day. Those individuals and an even larger number of their family members, friends, and relatives, must be able to count on nursing homes to provide safe, reliable, high quality care.

The National Nursing Home Quality Care Collaborative focuses on overall quality in nursing homes and uses a data-driven, proactive approach to eliminating or reducing preventable healthcare acquired conditions (HACs) including falls, pressure ulcers, C.difficile infections, urinary tract infections, and inappropriate antipsychotic use in persons with dementia. The collaborative framework provides nursing homes the opportunity to engage in quality improvement work. Nursing home teams can participate no matter where they are on the quality continuum.

The District’s collaborative name and motto is “Mission Possible- Creating Agents for Change”. The AQIN-DC QIO engaged 83% of the state’s nursing home community with key stakeholders from the trade association and our Department of Health partners. We discussed the goals of the collaborative with key stakeholders to ensure alignment with their priorities and goals – an attempt to avoid duplication of effort. This important step provided one message going out to our providers. Teams could focus their energies and not have to answer or respond differently to each organization’s requests.

09/2016 Collaborative One- Outcomes Congress Swearing in of new Mission Possible Change Agents

Our collaborative work began April 2015 and will continue through September 2018. Our approach to engage the participants includes webinars and live LAN events that address:

  • CMS’ collaborative change package, goal setting, Model for Improvement and PDSA.
  • QAPI principles and implementation.
  • Use of data to identify opportunities for improvement.
  • Subject matter expert speakers to cover collaborative topics.
  • Spotlighting teams and recognizing successes.

Teams receive monitoring and feedback through:

  • Technical assistance calls/visits to review progress with selected goals.
  • Each team’s senior leaders receives a quarterly facility progress report. Report identifies team’s progress on all collaborative measures, progress on composite score, and collaborative participation.

Results – Collaborative topics selected by most participants from Q4 2014 to Q2 2017

Quality  Measure

Q 4 2014 % rate
Prior to Collab-1

 Q 2 2017 % rate
Collab-2

Relative Improvement Rate

Antipsychotic use 13.7 10.3 24.8%
All falls 31.1 30.4 2.2%
Physical Restraints 0.3 0.1 66.6%
Urinary Tract Infection 5.5 2.7 50.9%

Lessons Learned by All

09/2017 Collaborative Two- Learning Session Two Learning about Antimicrobial Stewardship and Antibiotic Resistance

Teams have embraced the “all teach all learn” framework of a collaborative. Setting goals, monitoring the effects of interventions and sharing those successes has produced significant quality measure reductions in the state. The challenge will always be to rapidly spread the innovations and sustain the gains achieved.

How did we engage our collaborative community to achieve significant improvements? We learned:

  • Including key stakeholders early during planning stages for recruiting, and trainings brings benefit with their specific knowledge, people connections and shared resources.
  • Assisting providers in addressing immediate needs brings value to NH leadership and key staff.
  • Smaller collaborative groups create a sense of community, enhances peer networking, and team sharing.

This material was prepared by the Atlantic Quality Innovation Network (AQIN), the Medicare Quality Innovation Network-Quality Improvement Organization for New York State, South Carolina, and the District of Columbia, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 11SOW-AQINDC-TskC.2-17-23

AHQA Congratulates QINs on SIPS Awards

For Immediate Release
Date:         October 23, 2017
Contact:    Jonathan Gilad
Phone:       571-989-4173
Email:       Jgilad@ahqa.org

AHQA Celebrates Quality Improvement Networks on The Awarding of Special Innovation Grants by CMS

McLean, VA – Quality Improvement Networks (QINs) from across the country have been awarded 14 highly competitive Special Innovation Project (SIP) contracts from the Center for Medicare & Medicaid Services (CMS). SIPs are locally and/or regionally focused and seek to utilize innovative solutions to address a variety of health issues ranging from the opioid crisis to mental and behavioral health. Projects also prioritize patient- and family-centered solutions to health issues, with an emphasis on patient experience and health challenges specific to rural and urban areas.

The 14 QINs, which consist of regionalized Quality Innovation Organizations (QIOs), have a long history of successful work with CMS to improve health outcomes and reduce costs for Medicare patients. QIOs are leaders in finding inventive solutions to improve the quality of care for Medicare beneficiaries and adapt proven health solutions to better meet the needs of local communities.

“This latest round of SIP awards will allow for continued innovation and creativity within healthcare quality improvement—which really strikes at the heart of the QIO program,” said Alison Teitelbaum, executive director of the American Health Quality Association (AHQA), the leading trade association for the QIN-QIOs. “Many of these groundbreaking projects are in areas that support CMS’s strategic priorities, such as tackling opioid abuse and misuse, and they will be vital components in helping CMS reach its strategic goal.”

SIP award-earning projects and their respective AHQA member SIP contract recipients are as follows:

  • Addressing Opioid Misuse and Behavioral Health Disorders Using Innovative Interventions in Southwestern Ohio (Health Services Advisory Group (HSAG))
  • Chronic Kidney Disease Awareness and Prevention Program (CKD APP) (IPRO)            
  • Early Diagnosis and Treatment of Chronic Kidney Disease (CKD) via an Integrated, Systemic Approach Targeting At-Risk Beneficiaries with Diabetes and/or Hypertension (TMF)
  • EMS Integrated Health Care (Quality Insights)
  • Fighting Back Against Opioid Misuse – A Community Approach (QSource)
  • Improving Care Outcomes for Medicare Beneficiaries with Mental Illness and Opioid Use (GMCF)
  • Improving COPD-Related Health Care Utilization via the Use of a COPD Rescue Pack (TMF)
  • Local Quality Improvement Interventions: The Implementation of an Intervention to Improve the Ability of Rhode Island Nursing Homes to Serve Residents with Behavioral Health Needs (HealthCentric)
  • Opioid Safety: A Community Pharmacy Intervention to Prevent Opioid Adverse Drug Events (IPRO)
  • Patient, Family and Emergency Medical Service Early Recognition of Sepsis in Rural Communities: Critical to Reducing Progression of Sepsis Harm and Death (Great Plains)
  • Reducing Opioid Harms in Older Adults through Clinic Training and Technical Assistance (HealthInsight)
  • Special Innovation Project – Opioids Naloxone (GMCF)
  • The Preference-Aligned Communication and Treatment (PACT) Project (Telligen)

Since 1984 the American Health Quality Association (AHQA) has represented Quality Improvement Organizations (QIOs) and other professionals working to improve heath 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 healthcare in America.

Transforming Clinical Practice Initiative: Lake Superior QIN-QIO Supports Six Practice Transformation Networks with Baseline & Follow-Up Assessments

The Centers for Medicare & Medicaid Services’ (CMS) Transforming Clinical Practice Initiative (TCPI) is a key component of the new CMS Quality Payment Program. TCPI is uniquely designed to help 140,000 clinicians nationwide transform their practices from quantity of services to quality of care. Nationally, the 29 designated Practice Transformation Networks (PTNs) are charged with coaching and assisting clinicians in developing core competencies that prepare them to participate in Alternative Payment Models (APMs). In late 2015, 13 Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) were awarded contracts to assist the PTNs operating in their geographic regions. A key role of QIN-QIOs is to assess the clinician practices’ progress through five defined phases of practice transformation, by conducting TCPI baseline assessments and ongoing follow-up assessments for each practice.

‍From the start, Lake Superior QIN – the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Michigan, Minnesota and Wisconsin – put a high priority on establishing strong working relationships with the six PTNs operating in its region, which currently represent 700 practices and 7,000 clinicians. Building trust and creating ongoing communications were instrumental in the process. Project charters defined expectations and identified shared PTN/QIN-QIO measures. Once relationships were established, the Lake Superior QIN-PTN project teams worked collaboratively to develop efficient practice assessment processes – introductions, warm-handoffs, assessment feedback to PTNs and assessment submission to CMS.‍

Bill Sonterre, Lake Superior QIN’s TCPI regional lead, says, “The scope of the areas and processes involved in TCPI transformation is extensive. The assessments, which gauge a practice’s baseline, have been eye-opening for many of the practices. The assessments have shown them what they need to better understand in order to achieve transformation goals; the PTNs provide support to enhance processes to effectively achieve transformation strategies.”

Lake Superior QIN’s TCPI team has completed 253 baseline assessments to date, more than double its annual target of 100 baseline assessments. By July 2019, the QIN plans to complete 400 baseline assessments and 3,913 follow-up assessments. To achieve these ambitious targets, the current plans call for Lake Superior QIN to complete 100 percent of baseline and follow-up assessments for five of the PTNs, and a large percentage of the assessments for the sixth PTN. The strategy also calls for reaching out and supporting any new PTNs that may start operating in the three-state region.

Taking innovative steps, Lake Superior QIN is integrating TCPI with other QIN project work as budgets allow. Sonterre adds, “We’re getting a better feel for what each PTN is focusing on, so we can help the practices with quality improvements and meeting their transformation goals.”

This story is one of 15 that were included in the 2016 QIO Program Progress Report.

Special Innovation Project: Great Plains QIN-QIO Improves Colorectal Cancer Screening Rates

When CMS’ QIO Program announced a call for Special Innovation Projects (SIPs) in summer 2015, the Great Plains Quality Innovation Network (QIN) – the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Kansas, Nebraska, North Dakota and South Dakota – seized the opportunity to propose improving screening rates for colorectal cancer (CRC). CRC is the second leading cause of cancer deaths in both men and women and the third most commonly diagnosed cancer in the United States – and a particular threat in the Midwest. The four states served by the Great Plains QIN have CRC incidence rates that are higher than the national average and CRC screening rates that are far below the national average, particularly among the states’ Native American populations.

Since being awarded a SIP contract in September 2015, the Great Plains QIN has been working in support of the National Colorectal Cancer Roundtable’s “80% by 2018” initiative, which aims to reduce the number of new colon cancer cases and avoidable deaths nationwide by getting 80 percent of patients screened in each state. The Great Plains QIN has focused on recruiting clinics that serve the states’ rural and Native American populations, and has worked with those clinics to establish baseline screening rates and a systematic process for providing screening recommendations and reminders. To date, 82 percent of clinics throughout the four-state region have signed the “80% by 2018” pledge. One particular provider in Kansas, PrairieStar Health Center, implemented a consistent screening policy, patient reminders and electronic health record (EHR) notes across its five practices, and has achieved an 84 percent screening rate thus far.

‍Combining CRC screening with other CMS health quality priorities, like immunizations, has proven instrumental to screening improvements in rural areas, where the distance of colonoscopy centers and the lengthy preparation and testing processes, have presented barriers. The Great Plains QIN has helped flu clinics develop FLU-FIT (fecal immunochemical test) programs, offering at-home CRC tests to patients at the time of their annual flu shots. In collaboration with the American Cancer Society(ACS), the Great Plains QIN hosted a FLU-FIT webinar series to help clinics across the four states get FLU-FIT up and running. As a result, 30 sites launched FLU-FIT programs in 2016.

The Great Plains QIN’s partnerships with state, regional and national stakeholders have been a strong foundation for improvement throughout the region. The QIN has aligned with the ACS, local ACS affiliates, Centers for Disease Control and Prevention grantees, the Health Information Exchanges and Colorectal Cancer Roundtables in each of its four states, as well as partnered with the Great Plains Tribal Chairman’s Health Board and local public health units on or near the tribal areas to support efforts to improve CRC rates within the Native American population. “We and our partners share the same three-part aim of better care and better health at lower cost,” says Denise Kolba, RN, MS, CNS, Program Manager for the Great Plains QIN in South Dakota. “We know that improving CRC screening rates will help decrease the cost of treatment for cancers. In 2009, the mean total CRC cost per Medicare beneficiary was $29,196, which included 12 months of care but excluded things like home health and durable medical equipment. Even if we prevent just one case of colon cancer due to early screening in each of our 45 recruited clinics, we’ll save beneficiaries $1.3 million. Our SIP project will pay for itself.”

This story is one of 15 that were included in the 2016 QIO Program Progress Report.