American Health Quality Association’s (AHQA) QIN-QIOs are Pivotal in Reducing Costs for Medicare and Improving Health Quality, 2017 CMS Progress Report Reveals

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2017 CMS Progress Report reveals that QIN-QIOs are improving health quality and reducing costs to Medicare.

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No other quality improvement program in the country supports providers along the path that the patient travels through care—from inpatient setting to outpatient setting and beyond. That’s one of the hallmark characteristics of this program and of the QIN-QIOs themselves.

In a report released earlier this month, 2017 QIO Program Progress Report, the Centers for Medicare & Medicaid Services (CMS) revealed Quality Improvement Networks-Quality Improvement Organizations (QIN-QIOs) to be the most effective “Boots on the Ground” in the ongoing efforts to reduce costs for Medicare and improve health quality for millions of Medicare beneficiaries across the United States. The successful community- and provider-level work carried out by the QIN-QIOs in 2017, guided by the educational and advocacy support of the American Health Quality Association (AHQA), further cements the QIO Program as the preeminent Medicare Quality Improvement Program. CMS’s report detailed numerous meaningful and impactful achievements of QIN-QIOs in 2017; highlights include the following:

  • More than 4.7 million recruited Medicare beneficiaries impacted through education/outreach
  • More than 312,550 pneumonia immunizations administered
  • 600,000 flu immunizations administered
  • 2.3 million beneficiaries at high risk for an adverse drug event (ADE) were screened
  • 1.4 million medication-related adverse outcomes were identified for potential ADEs
  • The QIN-QIOS recruited more than 12,200 nursing homes (more than 78% of all nursing homes in the United States) to join their quality improvement efforts
  • 75.7% of tobacco users provided with cessation counseling, exceeding the 45% target

For every dollar spent on the program, the QIN-QIO program saved the U.S. government five dollars.

“These findings tell us what we already know. The QIN-QIO Program is the most effective and cost-efficient quality improvement infrastructure within CMS,” said Alison Teitelbaum, executive director of the American Health Quality Association (AHQA), the leading QIN-QIO trade association “When the QIN-QIO program was restructured in 2014, part of the aim of that effort was to streamline efficiencies so that best practices and innovations could be more easily spread across the country. It’s clear that this program is far exceeding those expectations. We’re confident that the QIN-QIO program, established by Congress and managed by CMS, can provide an even greater return, both financially and to the health of our nation, by being leveraged to its full statutory potential as we move forward," continued Teitelbaum. “It’s clear that the QIN-QIOs both help reduce costs through readmission and adverse medical event prevention and improve the quality of care for all beneficiaries.”

“The numbers here are definitive in what they inform us—that the QIN-QIOs continue to significantly improve the health and well being of Medicare patients nationwide. Our work and progress are a testament to our ability to partner with providers and healthcare facilities across the entire continuum of care,” said Dr. Russell Kohl, president of AHQA. “No other quality improvement program in the country supports providers along the path that the patient travels through care—from inpatient setting to outpatient setting and beyond. That’s one of the hallmark characteristics of this program and of the QIN-QIOs themselves.”

The 14 QIN-QIOs work with providers, community partners, and Medicare beneficiaries to improve patient safety, reduce health care disparities, and multiple other data-driven quality improvement measures. Separately, two Beneficiary and Family-Centered Care-QIOs (BFCC-QIOs) address all beneficiary concerns, quality of care reviews, and appeals under the QIO Program. This report shows the achievements that were made across the various clinical focus areas that were laid out by CMS for the QIO Program in 2017. The QIN-QIOs conduct these improvements under the direction of five-year contracts known as “Scopes of Work,” (SoW); the current SoW will conclude in 2019.

To read the full 2017 QIO Progress Report, visit https://progressreport.qioprogram.org/#section-1 (link is external). For more information about AQHA, contact info@ahqa.org (link sends e-mail).

Since 1984 the American Health Quality Association (AHQA) has represented Quality Improvement Organizations (QIOs) and other professionals working to improve health care quality and patient safety. AHQA is an educational, not-for-profit national membership association dedicated to promoting and facilitating fundamental change that improves the quality of health care in America.

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