CMS Special Session Quality Improvement Organization QIO 12th Scope of Work
The Centers for Medicare & Medicaid Services (CMS) hosted a CMS Special Session on April 20, 2017, to give all stakeholders, including the general public, the opportunity to provide feedback on the QIO Program 12th SoW. To share additional feedback, please email: QIOProgram@cms.hhs.gov.
Critical Access Hospitals: Billing Practices, the Quality Payment Program, and Quality Measurement and Policy Resources for Critical Access Hospitals
In providing technical assistance for quality reporting programs and the Quality Payment Program, both QIN-QIOs and SURs work to clarify the options for which eligible clinicians billing with CAHs are eligible for the QPP. This presentation includes an overview of claims billing for CAHs, QPP participation, and addressing questions submitted prior to the event.
Medicare Coding and Billing for Vaccinations

The QIN NCC and Ms. Edna Noré from the CMS Division of Financial Management Fee for Service Operations under the Medicare Fee-for-Service Branch hosted this informative call covering an introduction to Medicare beneficiaries vaccination coverage and detailed information on what forms should be used and how the billing works. This presentation identified the difference between vaccinations covered under Part B and Part D and diagnosis, procedure, and vaccination codes that should be used. Additionally, CMS presented on the seven top billing errors, roster billing details for hospitals and HHAs, and payment amount changes.

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MIPS in the Real World: How Your Peers Are Achieving Success

The New England Quality Innovation Network-Quality Improvement Organization (QIN-QIO) hosted an informative webinar on MIPS, which featured two Massachusetts practices that have discovered how they can successfully report for MIPS in the 2017 transitional year. Hosts Leila Volinsky, Kelsey Baker, and Karen Evans guided conversations with these practices to highlight real, attainable steps that they took in identifying measures and activities to support the new reporting requirements. This interactive webinar is ideal for clinicians, office managers, practice administrators, and anyone else who wants to learn about how they can easily avoid a negative payment adjustment for MIPS in 2017.

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Increasing Awareness of the Significance and Impact of Health and Healthcare Disparities
  • Background on Social Determinants of Health
  • Describe the Burden of Racial, Ethnic, and Economic Health Disparities
  • Understand Health Legislation and Policies

Brian Smedley, PhD Vice President and Director
Health Policy Institute Joint Center for Political and Economic Studies

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Healthcare Disparities Overview

Overview of Disparities (targeting QIO work)

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A Framework for Measuring the Triple AIM with Special focus on Equity & Disparities
  • Gain ideas and inspiration for measuring the Triple Aim
  • Show examples of including disparities in Triple Aim measurement

Guest Speakers:
Kevin Nolan, Mstat, MA Institute for Healthcare Improvement
Matt Stiefel, MPH Director, Center for Population Health, Kaiser Permanente
Sharon Takeda Platt, PhD Center for Healthcare Analytics, Hospitals, Quality and Care Delivery Excellence, Kaiser Permanente

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Strengthen and Broaden Leadership for Addressing Health Disparities at all Levels
  • Spread awareness of the impact of health disparities
  • Motivate others to take an active role in overturning the status quo
  • Build healthy and active partnerships between providers, patients, and communities
  • Empower communities to develop their own solutions
  • Create opportunities for patients and beneficiaries to become active agents of change
  • Coalition Building
  • Collaboration
  • Community Development
  • Leadership Empowerment

Allen Herman, MD, ChB, PhD, Disparities Subject Matter Expert
Becky Roberson, Senior Vice President Information and Quality Healthcare, Mississippi

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Affordable Care Act: Opportunities to Reduce Medicare Disparities
  • Provide an overview of the Affordable Care Act, providing examples of:
  • The major provisions that address health equity and health disparity.
  • Progress in terms of funding.
  • Opportunities for health equity
  • Understand the impact of ACA at the state level from the perspective of two QIOs - the “on the ground story

Regina Davis Moss, PhD, MPH, MCHES, Associate Executive Director, Public Health Policy and Practice, American Public Health Association (APHA) 
Rick Potter, CPA, MBA, CHCA, CEO, Health Services Advisory Group-California 
Margie Banse, Health Information Supervisor, Healthcare Excel-Kentucky

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Data Driven Action: Pathways to Health Equity
  • Accelerating Innovative Strategies to Engage Racial and Ethnic Minority Communities in Health Care
  • Why Race and Ethnicity Data Matters in Understanding Disparities

Jean Moody-Williams, CMS
Stephen Thomas, University of Maryland Center for Equity
QIO Panelists

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Diabetes Self-Management Training (DSMT) Reimbursement
  • Describe the beneficiary eligibility criteria for Medicare DSMT
  • List three of the Medicare coverage guidelines for telehealth DSMT
  • Name the procedure codes used to bill Medicare for DSMT

Speaker: Mary Ann Hodorowicz, RD, LDN, MBA, CDE, Certified Endocrinology Coder

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Driving Down Disparities: Innovations in Health Care Delivery, Communication and Technology
  • Using Data to Improve Care of High Cost, Complex Patients
  • Hotspotting, Digital Health
  • Case mix
  • New models for efficient and effective primary care (Equity and Quality)

Jeffrey Brenner, MD, Executive Director, The Camden Coalition of Health Providers
Clement Bezold, PhD, Chairman and Senior Futurist, Institute for Alternative Futures

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End of Life Care & Culture

Advanced Care Planning (African-Americans)

  • Understand the importance of planning for end-of-life care.
  • Assess the cultural and subjective norms of end-of-life care among African-Americans
  • Explore the factors that impact disparities in end-of-life care.

Thomas D. Harter, PhD, Associate Clinical Ethicist Medical Research, Gundersen Medical Foundation

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From Improvement to Activism
  • Building Trust and Capacity for Respectful Engagement (preliminary title) by Dr. Stephen Thomas, Director, Maryland Center for Health Equity, University of Maryland
  • Using Data for Health Equity (preliminary title) by Dr. Darrell Hudson, Assistant Professor, Brown School of Social Work and Faculty Scholar, the Institute of Public Health at Washington University in St. Louis

Ella D. Auchincloss, Director, ReThink Health: An Initiative of the Fannie E. Rippel Foundation

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Improving Quality & Achieving Equity: Delivering Culturally Competent Care to Diverse Populations
  • Cultural Competence and Quality: Goals and Drivers
  • Perspectives from Providers
  • A Checklist: The Patient-Based Approach

Speaker: Joseph Betancourt MD, MPH Director, The Disparities Solutions Center

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Language Services in Health Care
  • What are health care organizations required to do around cultural competency?
  • CLAS standards
  • National Linguistic & Cultural Programs

Marcos Pesquera, R.Ph, Executive Director, Center for Health Equity and Wellness, Adventist Healthcare
Oscar Lanza, IMG, Kaiser Permanente
Mercedes Blanco and Victoria Williams, MAXIMUS Center for Health Literacy Translation Services

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Patient Engagement Strategies: Innovations to Address Chronic Disease Disparities

Jane Kapustin, PhD, CRNP, BC-ADM, FAANP, FAAN
Assistant Dean for the MS and DNP Programs
University of MD School of Nursing

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People with Disabilities: A Health Disparities Population
  • Minorities with disabilities experience additional disparities
  • People with Disabilities have higher rates of obesity and diabetes than any other minority group
  • People with Disabilities are less likely to have access to regular medical care.
  • People Dually Eligible for Medicaid and Medicare

Speaker: Diane McComb, MSEd, Delmarva Foundation

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Taking Action to Reduce Disparities

Root Causes of Health Inequities: Explanations & Strategies

Richard Hofrichter, PhD, Senior Director of Health Equity,
National Association of County and City Health Officials (NACCHO)

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The Business Case for Reducing the Most Prevalent Medicare Chronic Conditions
  • Explore how health disparities contribute to health care costs in America.
  • Assess the direct health cost of disparities for Medicare beneficiaries.
  • Explain the relevance of co-morbidities.
  • Answer the question of “Why are health disparities important?”
  • Explain the purpose of the Business Case report

Shanta Whitaker, PhD, MPH, Senior Disparities Analyst

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Understanding and Reducing Rural Health Disparities
  • Discuss the differing definitions of “rural”.
  • Highlight prominent rural health disparities.
  • Provide an overview of organizations that support rural health
  • Explain the unique challenges for Rural Minorities: the “Double Burden”.
  • Introduce innovative projects in rural health
  • Understand QIO perspectives in meeting rural health challenges

Wayne Myers, M.D.
Former President of the National Rural Health Association, 2003
Director of the Office of Rural Health Policy, 1998-2000
Janice Probst, M.S., Ph.D., Director, South Carolina Rural Health Research Center

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Understanding Disparities among Dual Eligible with Mental Health Conditions

The Maryland Case and Guidelines for Analyzing Your Own State’s Story

  • Provide an overview of Hilltop’s recent report that assessed differences in chronic disease conditions among dual eligible Medicare and Medicaid beneficiaries with a mental health diagnosis based on two pathways: first enrolled in Medicaid or first enrolled in Medicare
  • Share methods, including use of the Chronic Condition Data Warehouse (CCW) so that quality improvement organizations (QIOs) can replicate this work in their respective states

Ian Stockwell, PhD, Director of Special Studies, The Hilltop Institute

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Understanding Health Disparities Using Data, Research and Evaluation
  • Understand the main reasons for the use of race/ethnicity/linguistic analysis of data for eliminating disparities
  • Understand the selection of performance measures for disparity measurement
  • Understand important statistical caveats when analyzing performance measures
  • Perspective or point of view: Medication Safety Officer and/or Pharmacist

Lenny Lopez, MD, MPH, Disparities Solutions Center
Jennifer Thomas, PharmD, MT, Delmarva Foundation 

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August 4, 2015 National LAN Call

This 1-hour recorded webinar will give providers a better understanding of how they can take full advantage of their participation with the QIO Program. Dennis Wagner, Director of the Quality Improvement and Innovation Group with the Centers for Medicare & Medicaid Services (CMS), describes the vision of the QIO Program, information on the benefits of working with regional Quality Innovation Network-QIOs (QIN-QIOs) and shares examples of local success stories and data involving providers, partners and patients.

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Intro to QAPI screen shot
Introduction to QAPI

This 16-minute recorded webinar is intended for nursing home staff participating in the National Nursing Home Quality Care Collaborative. Kelly O’Neill, with the Quality Improvement Network National Coordinating Center, describes QAPI and its five elements, CMS’ plans for the national rollout, and the value of QAPI beyond satisfying regulation. This brief overview may be helpful to nursing home staff as they are learning about the intent of QAPI.

Role of Tools in QAPI screen shot
Role of Tools in QAPI

This 16-minute recorded webinar is intended for nursing home staff participating in the National Nursing Home Quality Care Collaborative. Jane Pederson, with the Quality Improvement Network National Coordinating Center, introduces the role of tools in QAPI, and provides an overview of which tools are valuable and what each tool will help you accomplish. This brief overview may be helpful to nursing home staff as they are preparing for QAPI and looking for supportive tools designed specifically for long-term care, which align with each of the five elements.

Ventilator Associated Events (VAE) Education Webinar

This 1-hour recorded webinar is intended for hospital team members interested in learning more about Ventilator Associated Events (VAE) reporting. Cindy Gross, an infection preventionist from the Centers for Disease Control and Prevention, reviews VAE definitions and surveillance methods; describes important changes made to VAE surveillance and PNEU/VAP in 2015; explains the use of the VAE calculator; and describes how to correctly enter VAE data into the National Healthcare Safety Network.

Ventilator Associated Events (VAE) Educational Webinar - May 23rd, 2016:

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Mobility: Promoting Physical Activity for People Living in Nursing Homes

This 22-minute recorded webinar is intended for nursing home leadership and staff and provides an overview of strategies and resources to help maintain or improve mobility for people living in nursing homes. Specific topics include utilizing the Nursing Home Change Package and applying strategies from the mobility bundle into your nursing home, exploring use of the “Seven Dimensions of Wellness” model to support health and well-being, and understanding how using the Plan, Do, Study, Act Model for improvement can support quality in your nursing home.