CMS Restructures Quality Improvement Organization (QIO) Program — How the Changes Impact You Corley Roberts, MHA, CPHQ Tennessee Center for Patient Safety Regional Networking Meeting August 2014

Background Quality Improvement Organization (QIO) for State of Tennessee Contract with CMS to provide quality improvement and beneficiary protection services since 1973 Began exciting new, multi-state 5-year contract on Aug. 1, 2014 Qsource Tennessee offices in Memphis, Nashville, and Knoxville Our services are free Fact sheets (in development) New Quality Innovation Network website (to launch soon)

GOAL: Transform Healthcare Delivery Support learning systems Improve efficiency and increase value Achieve better health outcomes for beneficiaries

Restructuring Beneficiary and Family Centered Care (BFCC) QIOs #2 - Case Review and Monitoring Quality Innovation Network (QIN) QIOs #14 - Quality Improvement Activities 5-year contract cycle Began Aug. 1, 2014

For Our State BFCC QIO KEPRO 5700 Lombardo Center Dr., Suite 100 Seven Hills, OH Phone (844) Fax (844) Transition Questions: Frances Richardson, QIN-QIO atom Alliance, powered by Qsource

atom Alliance Partners Multi-state alliance for powerful change composed of three nonprofit, healthcare quality improvement consulting companies

The QIO Program’s Approach to Clinical Quality Goals Make care safer Strengthen person and family engagement Promote effective communication and coordination of care Promote effective prevention and treatment Promote best practices for healthy living Make care affordable

Quality Innovation Network (QIN)-QIOs What will they do? Champion local-level, results-oriented change Data driven Active engagement of patients and other partners Proactive, intentional innovation and spread of best practices that “stick” Facilitate learning and action networks (LANs) Creating an “all teach, all learn environment” Placing impetus for improvement at the bedside level – e.g., hand washing

Quality Innovation Network (QIN)-QIOs (cont.) Teach and advise as technical experts Consultation and education The management of knowledge so learning is never lost Communicate effectively Optimal learning, patient activation and sustained behavior change

atom Learning and Action Networks Provide targeted technical assistance to participating providers, stakeholders and communities in CMS quality improvement initiatives Engage providers and stakeholders in improvement initiatives through web-based Learning and Action Networks (LANs) atomalliance.org and Qnect will serve as hubs for the regional quality improvement work for each project, including: Project information Upcoming events Discussion forums Resource library Data portal Project maps and data Videos Recorded events

Promote Effective Prevention and Treatment of Chronic Disease Improving Cardiac Health and Reducing Cardiac Disparity Reducing Disparities in Diabetes Care Improving Prevention Coordination Through Meaningful Use of HIT and Collaborating with Regional Extension Centers

Make Care Safer by Reducing Harm Caused in the Delivery of Care Reducing Healthcare-Associated Infections in Hospitals Reducing Healthcare-Acquired Conditions in Nursing Homes

Promote Effective Communication and Coordination of Care Across Communities Integrate Medication Safety and Adverse Drug Prevention

Make Care More Affordable Quality Improvement Through Various Value-Based CMS Reporting Programs: Hospital Value-Based Purchasing (HVBP) Various Quality Reporting Requirements Across Settings (ASC, IPF, OQR) Physician Feedback Reporting (PQRS) Special Innovation Project Opportunities that Advance Efforts for Better Care at Lower Costs

Recruitment Begins Soon Visit new Web site for details Site will be available soon

TN Partnership for Patients Tennessee Hospital Association (THA) Tennessee Center for Patient Safety Hospital Engagement Network (HEN) Tennessee Department of Health atom Alliance, powered by Qsource

Partnership Goals Meet regularly Align efforts where common goals exist Ease provider burden Share resources

Thank You Questions? Lesley Hays, RHIA, CPHQ Patient Care Improvement, Manager This material was prepared by the atom Alliance, the Quality Innovation Network-Quality Improvement Organization (QIN- QIO), coordinated by Qsource for Tennessee, Kentucky, Indiana, Mississippi and Alabama, under a contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Content presented does not necessarily reflect CMS policy