Medicare Quality Improvement Initiatives

Transcription

1 Medicare Quality Improvement Initiatives Participation Opportunities in Minnesota February 2016 Achieve national quality goals in Minnesota. Join Stratis Health in working to achieve the Centers for Medicare & Medicaid (CMS) Quality Improvement Organization national quality goals in Minnesota. As part of Lake Superior Quality Innovation Network, Stratis Health partners with health care providers, stakeholders, and Medicare consumers and their families to make lives better through various quality initiatives. All initiatives have these benefits: Participation is free of charge Evidence-based, best practice tools and resources Technical assistance is available Educational resources and peer-to-peer learning Access to local, state, and national experts about interventions and lessons learned Note: Each program may not be actively recruiting participants. However, there are educational offerings available to all Minnesota organizations Behavioral Health Home Health Agencies Hospital Nursing Home Pharmacy Physician Offices Cardiac Health Coordination of Care Diabetes Care Hospital Healthcare-Acquired Infections Meaningful Use of Health IT Mental Health Improvement Nursing Home Quality Quality Reporting TCPI Practice Transformation

2 Cardiac Health Collaborate with providers to implement evidence-based practices to improve cardiovascular health and to reduce the incidence of heart attacks and strokes with a focus on underserved populations. Compare your practice against others using quality data benchmark reports, with recommended opportunities for improvement Standardize your electronic health record (EHR) documentation Participate in quality reporting initiatives, including Physician Quality Reporting System (PQRS) Engage patients in their care with new strategies Evaluate and redesign workflows to increase effectiveness For home health agencies: o Cardiovascular Data Registry assistance o Implement Best Practice Intervention Packages (BPIPs) through the Home Health Quality Initiative (HHQI) Jerri Hiniker, Program Manager, Stratis Health: jhiniker@stratishealth.org Coordination of Care Collaborate with community partners to improve transitions of care in the community and reduce hospital readmissions so people spend more days at home. Work collaboratively with community providers and stakeholders to establish common goals for improving coordination of care Access to qualified staff with expertise in care transitions and clinical quality improvement Convene with community coalition members with the purpose of peer-to-peer learning, networking, and solution sharing. Receive quarterly organizational-level and community-level readmission data reports Janelle Shearer, Program Manager, Stratis Health: jshearer@stratishealth.org

3 Diabetes Care - Everyone with Diabetes Counts (EDC) Program Empower patients to become more engaged in their diabetes self-care by using living room language and hands on activities that help understand difficult diabetes information (risks and complications) and become more adherent with treatment recommendations. Improve patients clinical outcomes related to HbA1c, lipids, eye exams, weight, blood pressure control, and foot care. Improve pay-for-performance metrics Assess the quality of care you provide to patients through quality reporting (clinical measures, PQRS, meaningful use, and value modifiers) Track improvement over time using periodic data benchmark reports Promote diabetes self-education support to patients through self-management workshops in your community and/or clinic Engage patients in their care with new strategies, materials, and community resources coordination Mary Beth Dahl, Program Manager, Stratis Health: mdahl@stratishealth.org Hospital Healthcare-Associated Infections Reduce and prevent healthcare-associated infections (HAI) for hospital patients by improving the culture of patient safety, care transitions, and efficiency; and by meeting and/or exceeding standards of care. Identify specific units for interventions using CDC Targeted Assessment for Prevention (TAP) reports Drive performance improvement for regulatory and accreditation requirements using National Healthcare Safety Network (NHSN) HAI data reports Compare your hospital against others using quality data benchmark and trend reports, with recommended opportunities for improvement Learn from national patient safety experts Be part of statewide partnerships to prevent and reduce CAUTIs, CDIs, CLABSIs, ventilatorassociated events (VAEs), and improve health care worker immunizations Kim McCoy, Program Manager, Stratis Health: kmccoy@stratishealth.org

4 Meaningful Use of Health IT Improve health for populations and communities by using health information technology (HIT) to improve prevention coordination. Use certified EHR technology to improve delivery of preventative services at point of care and through data analysis for population health Engage patients in their care with new strategies, including patient portals Understand changes to meaningful use Overcome barriers to meeting meaningful use requirements Align meaningful use with other CMS reporting programs: PQRS and value based modifier program Evaluate and redesign workflows to increase effectiveness Jane McGrath, Program Manager, Stratis Health: Mental Health Improvement Improve quality of care and patient satisfaction for people with depression and problematic alcohol use. Increase primary care screening to identify depression and alcohol use disorder, and improve inpatient care transitions for mental health conditions. Take advantage of reimbursement available from Medicare and Medicaid for screening Improve integration of primary and mental health care for seamless care delivery Develop improved processes for screening, care transitions, 7- and 30-day follow-up visits Avoid potential future penalties linked to unsuccessful transitions of care for psychiatric patients (similar to those for acute care hospital systems) Align with efforts across the region to promote safer, more effective transitions of care Network with care transition communities and providers to build potential referral sources and partnerships to reduce readmissions s: Joe Kalaidis, Health IT Consultant, Stratis Health Kim McCoy, QIN-QIO Director, Stratis Health

5 Nursing Home Quality Instill quality and performance improvement practices to eliminate healthcare acquired conditions (HACs), and improve resident satisfaction and quality outcomes. Succeed in your current improvement efforts, including Performance-Based Incentive Payment Program (PIPP), Quality Improvement Incentive Payment (QIIP), 5-Star Quality Rating System rating, and composite score Enhance your approach to Quality Assurance and Performance Improvement (QAPI) Create and sustain a culture that supports QAPI implementation Compare your home against others in the state, region, and nation using the composite score of the 13 CMS long stay quality measures Kristi Wergin, Program Manager, Stratis Health: kwergin@stratishealth.org Transforming Clinical Practice Initiative TCPI Stratis Health, representing Minnesota in Lake Superior QIN, has been chosen to play a lead role in the TCPI initiative based on our proven ability to engage health care professionals (clinician and administrative) in practice transformation efforts and our skill and experience in recommending successful quality improvement solutions that lead to large-scale change. TCPI, under a Centers for Medicare & Medicaid Services contract, is designed to help clinicians achieve large-scale health care transformation resulting in delivering better care, better health outcomes, and lower costs. Lake Superior QIN will be providing a variety of support to the five Practice Transformation Networks (PTNs) operating within our three-state service area. Bill Sonterre, Stratis Health, bsonterre@stratishealth.org

6 Value-Based Care, Physician Quality Reporting System (PQRS), and the Value Based Modifier Program Improve performance of care through the inpatient and outpatient quality reporting and the value-based purchasing programs. Improve health for populations through quality improvement efforts. Understand the Quality Resource Utilization Reports (QRURs) Align PQRS and value based modifier programs with other CMS reporting programs such as meaningful use Compare your hospital against others using quality data benchmark and trend reports, with recommended opportunities for improvement Target quality measures for improvement and monitor improvement performance rates Increase hospital value-based payment score and performance in quality reporting measures s Clinics: Candy Hanson, Program Manager, Stratis Health chanson@stratishealth.org Hospitals: Vicki Olson, Program Manager, Stratis Health volson@stratishealth.org This material was prepared by the Lake Superior Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 11SOW-MN-A