Qualis Health Wins Medicare Innovation Contracts to Improve Healthcare in Idaho and Washington

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Two-Year Projects Address Nursing Home Discharge Processes, Potential Overuse of Tests/Treatments

Qualis Health President & CEO, Jonathan Sugarman, MD, MPH

Qualis Health President & CEO, Jonathan Sugarman, MD, MPH

We’re pleased to apply our expertise in data analysis, quality improvement and evidence-based care to make a difference for our communities.

Qualis Health has been awarded two Special Innovation Project (SIP) contracts by the Centers for Medicare & Medicaid Services (CMS) to improve healthcare quality and value. CMS awarded SIP contracts to innovation projects that align with the goals of the CMS Quality Strategy and emphasize the power of partnerships.

“There is tremendous pressure on the American healthcare system to improve safety and value,” says Jonathan Sugarman, MD, MPH, Qualis Health President & CEO. “That pressure demands innovation and collaboration. We’re pleased to apply our expertise in data analysis, quality improvement and evidence-based care to make a difference for our communities.”

The awarded projects are:

Adapting Evidence-Based Tools and Engaging Patients to Develop Standardized Skilled Nursing Facility Discharge Processes. Many Medicare beneficiaries receive care in a skilled nursing facility (SNF) following a hospital stay, sometimes for a short duration. Qualis Health’s project will engage SNFs in Idaho and Washington to adapt and test hospital discharge tools for use in the nursing home setting, engaging residents and families in the discharge process for short-stay residents to reduce harm and the avoid the costs of unnecessary rehospitalization. This project expands on exploratory work undertaken by Qualis Health and two long term care associations, Leading Age Washington and the Washington Health Care Association.

Extending Choosing Wisely® in Washington State with Medicare Claims Analysis, Audit, and Feedback. Medically unnecessary services contribute to significant healthcare costs in the US. The Choosing Wisely® campaign focuses on avoiding wasteful or unnecessary medical tests and procedures. In 2014, the Washington Health Alliance published state and county data on 11 Choosing Wisely measures among commercially insured and Medicaid beneficiaries. Qualis Health will collaborate with the Alliance to publish a supplementary report using Medicare population data, including data on the use of antipsychotic medications to treat symptoms of dementia – a Choosing Wisely measure not previously reported. Qualis Health will provide confidential feedback and technical assistance to address potential overuse among high-utilizing clinicians.

Qualis Health is the Medicare Quality Innovation Network – Quality Improvement Organization for Idaho and Washington under contract to the federal Centers for Medicare & Medicaid Services. Its healthcare quality experts work with medical providers and consumers across the region to improve the quality of care for people with Medicare, working toward a vision of better healthcare, better community health, and lower costs.

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About Qualis Health

Qualis Health is one of the nation’s leading population health management organizations, and a leader in improving care delivery and patient outcomes, working with clients throughout the public and private sector to advance the quality, efficiency and value of healthcare for millions of Americans every day. We deliver solutions to ensure that our partners transform the care they provide, with a focus on process improvement, care management and effective use of health information technology. For more information, visit http://www.QualisHealth.org.

This material was prepared by Qualis Health, the Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO) for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. ID/WA-A1-QH-1918-10-15

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Evan Stults
Qualis Health
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