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Mountain-Pacific Quality Health QIO Orientation December 2011 Common Goals: • Health care is better • Health care is better for people AND COMMUNITIES • Affordable care through lower cost – by improvement National Quality Strategy Six Priorities that Build on the Broad Aims: Make care safer Promote effective coordination of care Assure care is person- and family-centered Promote prevention and treatment of the leading causes of mortality Help communities support better health Make care more affordable for individuals, families, employers and governments by reducing costs through continual improvement Alphabet Soup Anyone? EP ISA EH PNE Better Care, Lower Costs “A public-private partnership aimed at improving the quality, safety and affordability of health care for all Americans.” Two Goals: • Keep patients from getting injured or sicker • Help patients heal without complication Pledge Your Partnership! Visit the website: www.HealthCare.gov/center/programs/partnership See what organizations already joined: www.partnershippledge.HealthCare.gov Purpose of the New CMS Contract Four Goals/Aims: o Beneficiary- and Family-Centered Care o Improving Individual Patient Care o Integrating Care for Populations and Communities o Improving Health for Populations and Communities “Drivers” of Change Supporting and Convening Learning and Action Networks • Providing Focused Technical Assistance • Care Reinvention through Innovation Spread If my body were a car, I’d (CRISP Model) qualify for cash for clunkers! • Beneficiary- & Family-Centered Care Promote high-quality health care o Promote transparency and patient engagement o Optimize processes for providers and follow-up action for patients o Statutorily Mandated Case Reviews Quality of Care Reviews • EMTALA • APPEALS • Higher-Weighted DiagnosisRelated Group (HWDRG) Reviews • Improving Individual Patient Care o Reduce HACs by 40% o Reduce ADEs by 265,000 lives/year o Quality reporting and improvement Quality Reporting & Improvement Increase CAH participation and engagement in Inpatient/Outpatient data submission o Public Reporting Participation o Core Measure Quality Improvement o HCAHPS Participation o Hospital Inpatient Quality Reporting (IQR) National Hospital Inpatient Quality Measures: • • • • • • • Acute Myocardial Infarctions (AMI) Heart Failure (HF) Pneumonia (PN) Surgical Care Infection Prevention (SCIP) Emergency Department (ED) Stroke (STK) Venous Thromboembolism (VTE) Hospital Outpatient Quality Reporting (OQR) National Hospital Outpatient Quality Measures: • Outpatient Surgery • Outpatient Acute Myocardial Infarction (AMI) and Chest Pain • Imaging Efficiency Overlap/Alignment/Similarities = COLLABORATION Purpose of Reporting • Cost of care is among the most serious concerns within healthcare and public policy • Increased attention on the quality of care • Assessing the quality of care provided can help to identify opportunities for improvement Current Participants • 41 CAHs actively report Inpatient Data on a regular basis • 7 CAHs actively report Outpatient Data on a regular basis. • • 3 more CAHs have signed up to start reporting OQR 42 CAHs are signed up to publicly report data to Hospital Compare. Please note the difference in numbers is due to what we define as “actively” participating, which means you have submitted all eligible data for the last two most recent quarters Benefits of Reporting IQR & OQR • Engages your facility in quality improvement initiatives • Shows your community you are committed to transparency and quality improvement • Improves patient care and hospital services • Allows for clear benchmarking and the identification of best practices • Prepares CAHs for when CAHs will likely have to report measures for value-based purchasing (VBP) How Mountain-Pacific Can Help! You’ll receive: • Focused technical assistance and the use of data submission software and other programs to submit quality data • Training on hospital inpatient and outpatient quality reporting programs • Data, data, data and more data that will help to address areas for QI activities • Tools and other resources How to Participate Contact Mountain-Pacific Quality Health for Assistance: Shanelle Van Dyke Data Analyst Quality Data Reporting Project Lead 406-457-5896 (work) [email protected] Marcy Gallagher Quality Improvement Coordinator 406-457-5858 (work) [email protected] Christy Fuller MT Office Director 406-457-5829 (work) [email protected] Ericka Alm Quality Data Reporting Specialist 406-457-5811 (work) [email protected] Mary Danelson Quality Improvement Coordinator 406-457-5829 (work) [email protected] Colleen Roylance Quality Improvement Coordinator 406-457-5874 (work) [email protected] Integrating Care for Populations & Communities - (Care Transitions) o Reduce readmissions o Reduce emergency room visits o Improve patient care o Increase health care efficiency Aim Goals • Improve the quality of care for Medicare beneficiaries as they transition between providers • Reduce 30-day hospital readmissions by 20% over three years for the nation Improving Health for Populations & Communities o Promotion of immunizations and screenings o Cardiovascular health campaign Prevention Goals Improving Four Preventive Services: o Flu immunizations o Pneumococcal Vaccinations o Colorectal Screening o Breast Cancer Screening Improving Four Cardiac Health Measures: o Low-dose aspirin therapy o Blood pressure control o Cholesterol control o Tobacco cessation Reducing Disparities Putting a Face on Quality . . . Patients in the boardroom Telling stories QUESTIONS? Books are a nice change from reading prescription bottles. www.maxine.com This material was developed by Mountain-Pacific Quality Health, the Medicare quality improvement organization for Montana, Wyoming, Hawaii and Alaska, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Contents presented do not necessarily reflect CMS policy. 10SOW-MPQHF-MT-IPC-11-25