Archive for Press Releases

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. 

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.

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. 

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.

Statement on the 2016 QIN-QIO Progress Report

For Immediate Release
Contact:    Jonathan Gilad
Phone:       571-989-4173
Email:       Jgilad@ahqa.org    

Millions of Medicare Beneficiaries Benefit from QIO Program Work Across the Country 

2016 Progress Report Shows Achievements in Care Coordination and Quality Improvement

McLean, Virginia – Millions of Medicare beneficiaries from across the country benefited from the vital work of the Quality Improvement Organization (QIO) Program in 2016. Contracted by the Centers for Medicare & Medicaid Services (CMS), 14 Quality Innovation Network (QIN)-QIOs work regionally with providers and communities to improve the quality of care of Medicare beneficiaries. The breadth, depth, and scope of the Program’s work is detailed in the 2016 QIO Program Progress Report, released last week.

A few highlights from the report include (all numbers are for 2016):

  • Over 24,300 readmissions to hospitals avoided (with 350 communities engaged on how to reduce readmissions affecting a potential 23 million beneficiaries).
  • 27,850+ Medicare beneficiaries completed Diabetes Self-Management Education (DSME).
  • 3.7 million Medicare beneficiaries impacted through education and outreach about the importance of immunization.
  • Over 544,250 Pneumonia and flu immunizations administrated by clinicians and healthcare practices participating in the QIO Program.
  • Approximately 662,750 medication errors avoided.
  • 1.2 million Beneficiaries at high risk for an adverse drug event (ADE) screened, avoiding medication regime problems and unnecessary pain.

These numbers emphasize the extraordinary impact QIN-QIOs have on improving the quality of care for Medicare beneficiaries, which also reduces costs to CMS and the federal government.

“The 2016 Progress Report crystalizes the importance of the QIN-QIO network and why the QIO Program is the pre-eminent quality improvement program throughout the federal government. Thousands of practices and healthcare providers participate in the QIO Program, ensuring that we are on the ground working with almost every community across the country,” said Jane Brock, MD, MSPH, president of the American Health Quality Association (AHQA), the leading trade association for QIN-QIOs.

“The QIO Program helps put patients first by improving the quality of care people receive as part of Medicare. It’s thanks to the QIN-QIOs’ infrastructure that we continue to see advancement on all fronts in quality improvement for Medicare beneficiaries,” said Alison Teitelbaum, MS, MPH, CAE, executive director of AHQA.

The 14 QIN-QIOs work with providers, community partners, and Medicare beneficiaries to improve patient safety, reduce health care disparities, and other multiple, 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 have been laid out by CMS for the QIO Program.

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.