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Quality Update - Health care quality issues for Minnesota's health care leaders

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Latest News on the Medicare Quality Program

Montage of generic health care providersThe Centers for Medicare & Medicaid Services (CMS) launched its next five-year Quality Innovation Network-Quality Improvement Organization (QIN-QIO) program cycle on November 8. The work is planned to run November 2019 through November 2024.

Stratis Health, as part of the Superior Health Quality Alliance, will work in Michigan, Minnesota, and Wisconsin, to advance CMS’s priority national quality improvement aims:

  1. Improve Behavioral Health Outcomes, focusing on decreased opioid misuse
  2. Increase Patient Safety, including reducing adverse drug events
  3. Increase Chronic Disease Management, focusing on cardiac/vascular health, diabetes, and chronic kidney disease
  4. Increase Quality of Care Transitions, including reduced hospital readmissions
  5. Improve Nursing Home Quality

This work includes a major focus on rural and underserved populations and communities, as well as patient and family engagement. QIN-QIOs across the country will initiate improvement efforts focused on quality and patient safety at the community level. Facilities across the continuum of care—hospitals, clinics, nursing homes, home health agencies, pharmacies, and others—are invited to participate. Superior Health is engaging with stakeholders and partners in our region to align with ongoing initiatives and priorities.

Initiatives will foster better coordination and communication between organizations and among clinicians, as patients transition from one setting of care to another. Several specific largescale goals are outlined for the work. Community coalitions will improve quality of care for the majority of Medicare beneficiaries in the region, and at least half of those beneficiaries will represent rural or underserved populations. The work aims to increase access to behavioral health services for people who need but are not currently receiving them. QIN-QIOs will work with at least 70 percent of the nursing homes in their regions. Person and family engagement will improve, as measured by patient activation.

Stratis Health will be reaching out in the next few months to health care organizations and other stakeholders to participate in and support these quality improvement initiatives.

Clinician quality improvement

Medicare also is launching a clinician quality improvement initiative, which will address Aims 1-4. Stratis Health, as part of Superior Health, has submitted a proposal to lead a portion of this work. CMS’s clinician quality initiatives may be state-based in approach than the QIN-QIO initiatives and more focused on affinity groups with similarities in practice, such as rural or associated with a health system.

We expect the CMS awards to be announced late 2019, with actual work to begin in winter 2020.

Superior Health Quality Alliance

Superior Health Quality AllianceSuperior Health Quality Alliance aims to improve the quality of health and health care for health care consumers, patients, clinicians, health care organizations, and communities. Superior Health is a consortium of eight organizations with proven success driving achievement of Medicare quality improvement program goals. The members are Illinois Health and Hospital Association, MetaStar, Michigan Health & Hospital Association, Midwest Kidney Network, Minnesota Hospital Association, MPRO, Stratis Health, and Wisconsin Hospital Association.

Through Superior Health, Stratis Health continues our longstanding tradition of improving quality of care for Medicare beneficiaries.