CMSHealthDisparitie

9th SoW NATIONAL THEMES PREVENTION (CORE)
       

The Centers for Medicare & Medicaid Services’ (CMS) Quality Improvement

QIO interventions that support health information technology have the potential to improve screening rates through timely notification of providers and patients when a mammogram or CRC screening or immunization is needed.  It is worth noting that influenza and pneumococcal vaccination levels among adults 65 years of age and older remain well below the Healthy People 2010 objective of 90 percent. There is a need for more effective strategies for delivering vaccines to high-risk persons, their providers and household contacts.  Likewise, though breast and colorectal cancer incidence rates have declined overall, breast cancer remains the most common non-skin cancer in women and CRC is the third most commonly diagnosed cancer.


 
In Core Prevention, the national network of 53 QIOs is contracted to work with a selected group of participating providers (PPs) to implement effective interventions to improve rates for mammography and colorectal cancer (CRC) screening, and influenza and pneumococcal vaccinations among Medicare beneficiaries.  PPs with an electronic health record (EHR) certified by an officially recognized certifying body work with QIOs in this project to improve their rates.  As a result of using their EHRs, PPs are able to experience better communication between patients and providers that will ultimately improve access to timely information and physician office efficiency.

The primary tasks of QIOs in Core Prevention are to:
  • Recruit participating practices,
  • Identify a pool of non-participating practices (NPs),
  • Promote care management processes for preventive services using electronic health records (EHRs),
  • Complete Assessments of Care Processes,
  • Assist PPs and NPs with data reporting and submission,
  • Monitor statewide rates (mammograms, CRC screens, influenza and pneumococcal pneumonia immunizations) and disparities,
  • Produce an Annual Report including trend reports on PPs rates, Statewide rates, and Disparity rates, and analyses of interventions and barriers, and 
  • Provide an Optimization of Performance plan that includes strategies and timelines to improve and sustain performance.

QIOs are supported in their work on Core Prevention by the Prevention Quality Improvement Organization Support Center (Prevention QIOSC).  VHQC, the Virginia QIO, holds the contract for the Prevention QIOSC, and subcontracts with QSource and SoftDev to provide support to Core Prevention QIOs.  Please contact Robin Weil, Prevention QIOSC Director, for more information at rweil@vaqio.sdps.org.


The Prevention Theme: Chronic Kidney Disease
The Chronic Kidney Disease (CKD) Sub-National Task of the Prevention Theme focuses on timely detection and medical treatment of chronic kidney disease and improvement of treatment options and counseling for advanced kidney failure patients.  QIOs are partnering with providers in ten states and the U.S. Virgin Islands to slow the progression of chronic kidney disease to kidney failure and to improve clinical care for all kidney patients. 

The Prevention Disparities Theme also addresses health disparities through a Diabetes Self-Management Education (DSME) program in priority populations which will be assessed in terms of utilization and clinical outcomes.  Utilization data will be obtained through claims for HbA1c testing, eye exams, and lipid testing and through the Physician Quality Reporting Initiative (PQRI) measures for blood pressure testing.  QIO effort in the DSME component focuses on support for provider education to beneficiaries on diabetes self-management and is inclusive of community outreach with advocacy groups Federal partners and public and private entities in order to reach the intervention population. This is a sub-national task under the Prevention Theme.

QIOs are supported in their work on disparities by the Health Disparities Quality Improvement Organization Support Center (HDQIOSC). HCDI holds the contract for the HDQIOSC to provide support to the QIOS performing this Theme. Please contact healthdisparitiesqiosc@hcdi.com for more information.
HDQIOSC DISCLAIMER

This site was created by the HCD International’s Health Disparities Quality Improvement Organization Support Center through funding by the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, Contract # HHSM-500-2008-00028C