The Centers for Medicare & Medicaid Services has released plans for improving care in nursing homes and other facilities for its beneficiaries.
The plans come by way of CMS's latest contract for its Medicare Quality Improvement Organizations (QIOs).
According to CMS, this ninth and latest call for contracts will provide the agency with additional tools to better manage its QIOs by linking completed work to measurable outcomes over the three-year contract, set to begin in August.
Out of the 53 jurisdictions participating in the quality improvement organization, CMS is calling for organizations from eight states – California, Minnesota, Mississippi, North Carolina, Nevada, New York, Oklahoma and South Carolina – to compete in this latest round of contracts. Organizations in these states did not meet all of the performance criteria required for automatic renewal.
According to CMS officials, those organizations reapplying to participate must improve care in beneficiary protection, care transitions, patient safety and prevention.
In addition, QIOs will be required to help Medicare promote the adoption of value-driven healthcare, the use of health information technology and the reduction of health disparities in their communities.
Under the new contract, QIOs will be required to offer help to specific nursing homes and hospitals that have not recently performed well on important quality measures, CMS officials said.
A Government Accountability Office report released last year indicated the CMS needs to improve quality of care at nursing homes. CMS officials said they plan to accomplish this goal through this new round of contracts.
Under the new contracts, QIOs will concentrate their efforts on facilities with the greatest opportunity for improvement in care, identified by the CMS on its Web site as part of the contract solicitation.
"By posting information about these facilities, CMS strengthens its commitment to increasing the transparency of information available to consumers in the healthcare market by providing the public with the information needed to make informed choices about healthcare," the CMS said.
In addition to those facilities identified by CMS as needing help, QIOs applying under the new contract will also have the opportunity to choose 15 percent of facilities based on their own criteria.
The Quality Improvement Organization Program was created by statute in 1982 to improve the quality, safety and efficiency of health care services delivered to Medicare beneficiaries.
QIOs are Medicare contractors hired to work with healthcare providers such as home health agencies, hospitals, nursing homes and physicians' offices to improve healthcare services for beneficiaries.