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.

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. 

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.

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. 

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

QIN-QIOs Reach Crucial Goal in the Effort to Improve Health Quality in the Nation’s Nursing Homes

Effort to Gather Data on Incidents of Nursing Home C. difficile Infections Reaches Nationwide Target

McLean, Virginia – Quality Innovation Networks (QIN), which are comprised of regionally-focused Quality Improvement Organizations (QIO) across the country, have reached their target of enrolling 2,336 nursing homes in the Center for Disease Control’s (CDC) National Healthcare Safety Network (NHSN). The NHSN is the most widely used healthcare-associated infection (HAI) tracking system in the US. It is currently used by most hospitals and dialysis facilities, but not yet extensively used by nursing homes.

With the achievement of this goal, nursing homes will focus on collecting and entering data on Clostridium difficile infections, a bacterium that causes inflammation of the colon, known as colitis. The CDC will, for the first time, be able to calculate a baseline C. difficile long term care facility incidence rate for 2017. QIN-QIOs can proactively track individual nursing homes’, state, and national nursing home C. difficile infection rates, which are key steps in helping facilities develop ways to lower infections.

This effort was accomplished through federal cross-agency collaboration between the Centers for Medicare & Medicaid Services (CMS) and the CDC, and through the diligent work of QIN-QIO community-based partnerships networked throughout the country. QIN-QIOs, which are divided into 14 regional networks, work with providers to help improve health quality in every state and community. 

“This is just one example of the incredible, wide-reaching work that the QIN-QIO program can accomplish through its unique collaborative network of healthcare providers. With this latest effort complete, the difficult task of reducing nursing home infections can begin,” said Alison Teitelbaum, MS, MPH, CAE, executive director of the American Health Quality Association (AHQA), which is the leading trade association for the QIN-QIO program.

“This project wouldn’t be possible without the outstanding work of the QINs and QIOs in every community working to recruit and enroll nursing homes. The National Action Plan to Prevent Healthcare- Associated Infections set a goal of enrolling 5% of nursing homes in the NHSN reporting database within 5 years.  It’s a testament to this extraordinary effort by the QIN-QIOs to note that we are now surpassing this goal, with the potential to have almost 15% of nursing homes nationwide reporting data. Once we have real time data on infections through the NHSN, we can truly begin to innovate and improve the quality of care provided in nursing homes across the country,” said Dr. Jane Brock, MSPH, president of AHQA.

According to the CDC the “NHSN provides facilities, states, regions, and the nation with data needed to identify problem areas, measure progress of prevention efforts, and ultimately eliminate healthcare-associated infections.”

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. 

For Immediate Release

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

American Health Quality Association Congratulates Seema Verma on Her Confirmation as Administrator of the Centers for Medicare and Medicaid Services

McLean, VA – The American Health Quality Association (AHQA) congratulates Seema Verma on her confirmation as the Administrator of the Center for Medicare and Medicaid Services (CMS) in the Department of Health and Human Services (HHS). With her confirmation complete, AHQA looks forward to working with Ms. Verma to advance the health quality agenda and the Triple Aim of providing better care, lower costs, and improved health.

AHQA represents the Quality Innovation Network (QIN) – Quality Improvement Organizations (QIOs), who work with health care providers to ensure that the most current, clinically proven techniques and practices are adopted in order to deliver safe, high quality care to Medicare beneficiaries. QIOs, who work in all 50 states and US Territories, are at the forefront of innovation and uplifting the quality of healthcare for Medicare recipients while reducing costs to the system. 

“AHQA is eager to continue our collaborative relationship with CMS under the guidance and direction of the new administration. We would welcome the opportunity to share the critical work and tremendous success of the QIO program with Ms. Verma and her staff,” said AHQA executive director, Alison Teitelbaum, MS, MPH, CAE.

While Ms. Verma was not asked directly about the QIO program in her confirmation hearing, related work was discussed, such as improving health quality, emphasizing patient-centered care, and reducing costs. Since their inception, QIOs have excelled in innovative ways to address these issues and better the US healthcare system. 

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.

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

AHQA Congratulates Quality Innovation Networks on Being Awarded CMS Contracts to Assist Underserved and Rural Practices Preparing for MACRA

McLean, VA – Quality Improvement Networks (QIN) from across the country have been awarded contracts from the Centers for Medicare and Medicaid Services (CMS) to help providers in small practices and in underserved and rural areas, succeed in the new Quality Payment Program (QPP).

The 14 QINs, which consist of state-based Quality Innovation Organizations (QIO)s, have a long history of successful work with healthcare providers to improve health outcomes and lower costs for Medicare patients. Nine of the 11 award recipients are QIN-QIOs.

“Providers in small group practices, as well as underserved, rural, and frontier areas, are critical components of our nation’s healthcare system. These awards will allow QINs to activate their extensive, community-based networks around the country to provide in-depth, tailored technical assistance to these providers,” said Dr. Jane Brock, MD, MSPH, President of the American Health Quality Association. “We applaud CMS for recognizing and supporting the unique needs of these providers and for leveraging the capabilities of the QIN-QIO program to drive this important work.”

In particular, these contracts will help small healthcare providers navigate the new payment system in a way that maximizes both patients’ care and healthcare provider reimbursement. This payment system was authorized under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)  and articulated by CMS in its “Quality Payment Program Final Rule” in October 2016.  MACRA aims to shift the Medicare payment system away from a billing-for-service system towards a billing-for-value system called the Quality Payment System.

As part of its effort to reward clinicians for value of care as opposed to volume, MACRA will also eliminate the Sustainable Growth Rate Formula for physician reimbursement, create a merit-based incentive payment system, and institute bonus payments for clinicians who participate in Alternative Payment Models (APMs).

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

FOR IMMEDIATE RELEASE
Contact: Alison Teitelbaum
Phone: 703-506-7669

CMS Awards Special Innovation Projects to 12
Regional Quality Innovation Networks-Quality Improvement Organizations

McLean, VA — The Centers for Medicare & Medicaid Services (CMS) continues to drive efforts for better care, smarter spending, and healthier people by awarding 20, two-year Special Innovation Projects (SIPs) to 12 regional Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs). This is the second round of SIP awards in consecutive years. These SIPs focus on evidence-based practice and allow for local innovations that advance local efforts for better care at lower costs and national impact interventions that are ready for spread and scalability to address critical healthcare quality issues. Specifically, these SIPs address quality of life improvement for residents in nursing homes, the reduction of opioid misuse, improvement in chronic care management, and the acceleration of treatment for better stroke outcomes among other crucially important healthcare quality issues. 

These SIPs align with the CMS Quality Strategy to improve population health, provide better care for individuals, and lower cost through improvement. The outcomes of these projects will be used to further develop the QIO Program, the engine driving greater connectivity and coordination across all settings and providers to transform healthcare delivery for America’s Medicare beneficiaries. These SIPs allow providers, organizations, patients, and others to impact healthcare quality at local and national levels through the QIO Program’s Strategic Innovation Center, which furthers the CMS Quality Strategy by quickly implementing these innovative healthcare quality improvement projects and spreading evidence-based practices to communities.

“The QIN-QIOs are excited about the opportunity to implement these new initiatives, which encourage flexible and innovative approaches to improving the lives and health of Medicare beneficiaries,”  said Jane Brock, MD, MSPH, President of the American Health Quality Association.

The SIPs awarded were rigorously vetted by CMS prior to funding. Those QIN-QIOs awarded proposed projects that were scientifically sound, had a strong analytic framework, contained interventions based on evidence, and demonstrated sound local, regional, and national partnerships that furthered CMS Quality Strategy goals.

“The SIP program is an exciting initiative in which the QIN-QIOs will be able to showcase their tremendous skill and expertise at effecting meaningful health quality improvement in targeted areas” said Alison Teitelbaum, MS, MPH, CAE, Executive Director of the American Health Quality Association. “We are extremely proud of the work all our QIN-QIO members do to advance the quality of care across America.”

A complete list of 2016 SIP awardees is located on the QIO Program website

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The American Health Quality Association (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 represents Quality Improvement Organizations (QIOs) QIN-QIOs and other professionals working to improve health care quality and patient safety.

AHQA maintains close working relationships with the Centers for Medicare & Medicaid Services (CMS) at the Department of Health and Human Services (HHS) and national professional medical and health care associations—serving as a professional resource and partner on projects.

In addition, AHQA regularly works with lawmakers, regulators, health care providers, and consumers to advocate its policies and to gain support and visibility for the goals and accomplishments of its members.

HealthInsight Quality Innovation Network – Quality Improvement Organization (QIN-QIO) will be partnering with Indian Health Service (IHS) hospitals to help them continuously improve quality of care under a new project announced earlier this month. HealthInsight has a history of strategic partnerships that support quality improvement and innovation in hospitals across multiple states and has teamed up with the Oklahoma Foundation for Medical Quality, three QIN-QIOs (Mountain-Pacific Quality Health, Lake Superior and Great Plains) as well as Ironside Consulting, LLC, a Native American owned health care consulting company, for this work. HealthInsight and partners have a strong track record of supporting IHS hospitals within their states to improve care across a variety of projects.

 “Our desire to build capacity for quality improvement and achieve excellence in the IHS hospitals is matched by our respect for patient, family and tribal needs, desires and wishes” said HealthInsight President and CEO Marc Bennett.

The overarching goals for the project are to support, build, and if needed, redesign IHS hospital operating infrastructure in order to provide high-quality health care services to Medicare beneficiaries. The contract will focus on leadership, staff development, data acquisition and analytics, clinical standards of care, and quality of care related to the Medicare program. The QIN-QIOs involved cover the majority of the Southwest and Midwest regions including Arizona, Minnesota, and the Dakotas, and Montana, while also covering the sizeable Native Alaskan population. This large geographic partnership will allow the work to affect a majority of the IHS hospitals.

QIOs have been working on behalf of the Centers for Medicare & Medicaid Services (CMS) since 1984 to help improve health care delivery, safety, and efficiency in every U.S. state and territory through a combination of:

• Improvement collaboratives with local health care providers and provider organizations
• Targeted assistance for individual health care providers
• Direct intervention with Medicare beneficiaries and the health care community

QIOs are private, mostly not-for-profit, organizations staffed by teams of physicians and other health care quality experts. QIOs work directly with health care providers—such as hospitals, physicians, nursing homes, and home health agencies—to ensure the most current, clinically proven techniques and practices are being put in place to deliver the safest and highest quality care.

For more information on the QIN-QIO program, please visit the American Health Quality Association website.

To read the full CMS Press Release, visit the CMS website.

New CMS Program Expands the Work of the Quality Improvement Organizations

The following is AHQA’s Statement on the HIIN Awards. For a PDF version of the release, please click here.

Over the past 4 years, the Quality Innovation Networks – Quality Improvement Organizations (QIN-QIOs), in partnership with Partnership for Patients and Hospital Engagement Networks, have made significant progress in keeping patients safe – including an estimated 2.1 million fewer patients harmed, 87,000 lives saved, and nearly $20 billion in cost-savings. CMS’ newly announced program, the Hospital Improvement and Innovation Network (HIIN), has been awarded $347 million to continue this important work and integrate new national, regional, and state hospital associations and health system organizations into the QIO family.

Building on this shared success, new, ambitious goals have been set for the HIIN program. Through 2019, these Networks will work to achieve a 20 percent decrease in overall patient harm and a 12 percent reduction in 30-day hospital readmissions as a population-based measure (readmissions per 1,000 people) from the 2014 baseline. The establishment of these new goals raises the bar for improvements in patient safety in the acute care hospital setting.

“The QIN-QIOs are excited and anxious to collaborate with a broader quality improvement network under the HIIN program and commend CMS for developing a program that will maximize our reach as QIOs,” said Jane Brock, MD, MSPH, President of the American Health Quality Association. “Together, we will be able to have even greater impact as we continue to play a significant role in building a system that delivers better care.”

QIOs have been working on behalf of the Centers for Medicare & Medicaid Services (CMS) since 1984 to help improve health care delivery, safety, and efficiency in every U.S. state and territory through a combination of:

• Improvement collaboratives with local health care providers and provider organizations
• Targeted assistance for individual health care providers
• Direct intervention with Medicare beneficiaries and the health care community

QIOs are private, mostly not-for-profit, organizations staffed by teams of physicians and other health care quality experts. QIOs work directly with health care providers—such as hospitals, physicians, nursing homes, and home health agencies—to ensure the most current, clinically proven techniques and practices are being put in place to deliver the safest and highest quality care.

For more information on the QIN-QIO program, please visit the American Health Quality Association website.

For more information on the HIIN announcement, please visit the CMS website.

Printable release: AHQA Statement on the HIIN awards.pdf