Resource Library-How Can We Work Together to Improve Healthcare Quality for All Americans

Video Transcription

Video Summary

CMS’s Quality Improvement and Innovation Group outlined how its programs improve healthcare quality through partnership and data-driven support. The Beneficiary and Family Centered Care (BFCC) program assisted nearly 2 million Medicare beneficiaries in five years through appeals, complaints, and rapid advocacy, and protected the Medicare Trust Fund by recovering over $100 million from claims errors. CMS previewed the next Quality Innovation Network–QIO (QIN-QIO) scope (2024–2029), focused on rebuilding providers’ quality systems with an emphasis on health equity, then advancing prevention, chronic disease management, patient safety, behavioral health, and care coordination, including rapid emergency response. Reported impacts include improved nursing home COVID outcomes, reduced C. diff hospitalizations, fewer opioid adverse drug events, better cardiac rehab uptake, slower progression to ESRD, and fewer readmission harms. Additional work includes improving outcomes in American Indian/Alaska Native communities and expanding home dialysis and transplants via ESRD networks and disaster preparedness support. A three-part strategy emphasizes aligned national aims, locally tailored interventions (AC3: assess, coordinate/complement/create), and broad coalitions while continuously scanning for innovation.

Asset Caption

Speakers: Paul Rosen, MD, MPH, MMM, Anita Monteiro, MBA, MSHCA, MA, BSN, Scott Lawrence, DC

Healthcare Quality must be a top priority for our nation. The Quality Improvement Organization (QIO) Program, run by the Centers for Medicare and Medicaid Services (CMS), is one of the largest federal programs dedicated to improving health quality for Medicare and is an integral part of the U.S. Department of Health and Human (HHS) Services’ National Quality Strategy for providing better care and better health at lower cost. By law, the mission of the QIO Program is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. CMS regularly evolves our programs to accomplish these goals.

Meta Tag

Competency Tag QLI1

Competency Tag Description Direct the quality and safety infrastructure to achieve organizational objectives.

Domain Tag Quality Leadership and Integration

Keywords

CMS Quality Improvement and Innovation Group

Beneficiary and Family Centered Care (BFCC) program

Quality Innovation Network–QIO (QIN-QIO) 2024–2029 scope

health equity and data-driven quality improvement

ESRD networks, home dialysis and transplant expansion