New Direction for Medicare QIO Work

The Centers for Medicare & Medicaid Services (CMS) has laid out a new direction for its national health care quality improvement program, implemented through the Medicare Quality Improvement Organizations (QIOs) nationwide. It is based on the U.S. Department of Health and Human Services' National Quality Strategy, called for under the Affordable Care Act, which is the first effort to create national aims and priorities to guide local, state, and national efforts to improve the quality of health care in the United States.

From August 2011 through July 2014, Stratis Health's work as the QIO for Minnesota will be based on the National Quality Strategy's three broad aims: better health care, better health for people and communities, and affordable care through lowering costs by improvement.

The key themes for the upcoming quality improvement work include:

Beneficiary and family centered care

• Implementing a case review program to respond to quality of care concerns, appeals, utilizations reviews, and Emergency Medical Treatment and Labor Act (EMTALA)
• Patient and family engagement
  

Improving individual patient care

Make care safer and more affordable by:

• Reducing health care acquired conditions, including infections and pressure ulcers
• Reducing physical restraint use in nursing homes
• Reducing adverse drug events
• Enhancing hospital quality reporting
  

Integrating care for populations and communities

Improve quality of care for beneficiaries who transition between care settings by:

• Reducing readmissions following hospitalizations

Improving health for populations and communities

Work with providers to use their electronic health record systems for:

• Improving prevention through screening and immunizations
• Improving prevention in cardiovascular disease and early diagnosis through improved use of technology
• Facilitating physician participation in national quality reporting

Stratis Health will support care reinvention through the spread of innovations by providing training and technical assistance on clinical quality, teamwork, organizational culture, and leadership; leading local learning and collaborations by facilitating strategic partnerships; and supporting and convening learning and action networks.

Some aspects of this work continue or build upon past QIO work. This work is framed to have great impact and a broad reach. It will tap into Stratis Health's experience and expertise in leading learning collaboratives through several learning and action networks, focused technical assistance based on evidence based best practices, and strategies to spread innovation.

Stratis Health has served as Minnesota's Medicare Quality Improvement Organization since the program's inception in the 1970s. Through the next Medicare QIO body of work, we will collaborate with many health care organizations and providers, and engage consumers, to accelerate and broaden the impact of quality improvement, and continue to lead measurable improvements in care for Minnesota's 780,000 Medicare consumers.