Healthcare Providers and Professionals
Partnerships for Improvement
In 1992, the Centers for Medicare & Medicaid Services (CMS) and its contractors, Quality Improvement Organizations (QIOs), initiated the Healthcare Quality Improvement Program (HCQIP), a new approach to improve the health of Medicare beneficiaries. HCQIP involves analyzing and changing the patterns of care to remedy widespread short-comings in the healthcare system. Collaboration is critical to the success of HCQIP. It represents an historic opportunity to partner with practitioners, beneficiaries, providers, plans, and other purchasers to:
- Develop quality indicators firmly based in science
- Identify opportunities to improve care through careful measurement of care patterns
- Communicate with professional and provider communities about these patterns of care
- Intervene to foster quality improvement through system improvements
- Remeasure to evaluate success and redirect efforts
National Priorities
CMS has identified several clinical areas as national priorities. These national priorities were chosen based on their public health importance and the feasibility of measuring and improving quality. All are important causes of morbidity and mortality among the Medicare population and the U.S. population as a whole, and account for substantial number of hospitalizations and healthcare costs. To ensure that HCQIP efforts will truly improve health, the quality indicators for these clinical conditions are firmly based in science.
CMS and QIO Accountability
For the first time since the QIO program's inception, more than two decades ago, CMS has developed performance-based contracts with QIOs (such as KFMC in Kansas) to improve patient outcomes nationwide. These improvements can be accomplished only through collaboration with healthcare professionals and providers. The success of this national effort, as well as KFMC's success on the state level, hinge on fostering successful partnerships to improve care for patients.
Benefits to Collaborating Providers
QIOs provide quality improvement consultation to healthcare professionals, hospitals, physician practices, managed care organization, and others. This includes:
- widely accepted quality indicators and data collection instruments
- Analysis and feedback of state and facility-level data about patterns of care
- Effective quality improvement strategies and expertise
- Pre-tested educational materials for providers and patients
- A forum for collaboration among providers, payers, and others to improve care and increase the value of healthcare expenditures.
CMS has awarded a three-year contract to KFMC to conduct this work to improve the health and safety of Medicare beneficiaries. KFMC employs physicians, nurses, healthcare quality professionals, epidemiologists, statisticians, and communication experts, and does not charge partners or collaborators for their services.
Healthcare professionals, providers, and national and local organizations are encouraged to adopt Medicare's Healthcare Quality Improvement Program priorities and to work with KFMC to foster improvement activities to improve care for all patients, regardless of age, payer or setting of care. Providers will achieve a higher quality of care and improve outcomes for individuals across the nation by working in partnership with CMS and KFMC.
To learn more about current Healthcare Quality Improvement Projects, please call 1-800-432-0770 or email the Healthcare Quality Improvement Team.
