Medicare's Quality Improvement Organizations had a banner year, according to a 2015 progress report that shows the organizations exceeded recruitment targets for six initiatives, prevented thousands of improper early discharges and saved more than $9.4 million.
The program aims to drive rapid and large scale change that puts patients first, contributing to the Triple Aim goals of improved care, better population health and lower costs. There are two types of organizations: Quality Innovation Network-QIOs (QIN-QIOs), which work with providers to improve patient safety and reduce harm, and Beneficiary and Family Centered Care-QIOs (BFCC-QIOs), which manage all beneficiary complaints and appeals to ensure the patients are treated fairly.
The report revealed that in its first year of existence, the two BFCC-QIOs identified more than 1,900 opportunities for quality improvement during 6,400-plus reviews of quality of care concerns. They also reviewed 172,482 cases and saved $9.4 million through Higher Weighted Diagnosis-Related Group reviews, according to CMS.
Ten of the 14 regional QIN-QIOs were awarded partnership-driven special innovation projects worth a total of nearly $10 million in 2015, according to the report. All 14 received four-year contracts to improve immunization rates and reduce immunization disparities among Medicare beneficiaries. They exceeded goals for care coordination and nursing home care, including the recruitment of more than 1,000 clinicians to provide diabetes self-management education.
To learn more:
- here's the CMS progress report