Health Care Consumers

Stratis Health works to improve the quality of care deliver to and safety of health care consumers. We help identify best practices in health care processes and procedures and work with the health care providers to adopt these practices to improve care for all of their patients. For example, we work with:

• Clinics to help them adopt electronic health records so they can easily identity potential harmful drug interactions and be reminded of when specific medical tests are needed
• Hospitals to support their reporting of quality data so health care consumers can better understand the quality of care being delivered
• Nursing homes to help them change from institutional facilities to places that can truly be called home for the people who live there
• Home health agencies to increase early monitoring of new clients coming from hospital stays, so they will not need to be re-hospitalized

Protecting Medicare Consumers and the Medicare Trust Fund

As part of our work as the Quality Improvement Organization for Minnesota under contract with the Centers for Medicare & Medicaid Services, Stratis Health informs Medicare beneficiaries of their rights and responsibilities under the Medicare program, and how to navigate the Medicare system. We have over 35 years experience in conducting medical case review, determining whether services provided were reasonable and medically necessary, were provided in the most appropriate setting, met professionally recognized standards of health care, and were appropriately billed.

During our three-year QIO contract from 2008-2011, we responded to nearly 3,500 requests for Medicare medical record reviews, including beneficiary complaints, coverage and discharge appeals, hospital admissions appeals, and quality of care concerns.

Stratis Health supports Medicare consumers in Minnesota by maintaining a helpline—providing callers with information concerning Medicare rights and responsibilities, protections, and various QIO programs and initiatives. We coordinate alternative dispute resolution on behalf of Medicare consumers and their providers, and third party mediators when needed. During our last QIO contract, we:

• Fielded 4,450 help-line calls
• 97% of case reviews completed in a timely manner
• Over 90% of beneficiaries were satisfied with our complaint review process

Medicare is committed to making information about health care performance available to consumers and giving them additional tools for decision-making. Stratis Health supports this transparency in health care quality and patient safety by working with all Minnesota hospitals to collect and submit quality data and by offering educational and technical assistance to them on the use of CMS reporting systems and tools.

Adverse Events

When adverse health care events—medical errors that should never happen—happen in Minnesota, Stratis Health reviews and analyzes the reports submitted by the health care facilities. We support facilities in their efforts to identify the root cause/source of the problem so the health care provider can correct the problem in order to prevent it from causing future medical errors. More>

Community Outreach Committee

Since 1982, the Stratis Health has sponsored the Community Outreach Committee to facilitate the flow of health care information among Medicare beneficiaries, community and senior advocacy organizations, and government, and to provide guidance for outreach activities. The group meets quarterly to discuss timely topics impacting Medicare beneficiaries.