Several
major initiatives evolved as a result of the Affordable Care Act and all will
have a significant impact on quality and improving health care. This newsletter will share information on the
National Quality Strategy, the CMS Innovation Center and the Transforming Clinical Practices
Initiative.
The National Quality Strategy
Mandated by
the Affordable Care Act, this strategy was developed through a collaborative
and transparent process with input from a wide variety of stakeholders. There are three overarching aims, six
priorities that address the most common health concerns for Americans today and
nine levers to assist stakeholders in aligning their functions to drive
improvement.
The NQS
provides a focus for addressing the abundance of clinical quality measures
currently used in national programs.
This initiative has three broad aims:
- Better Care – improve the overall quality by making healthcare more patient-centered.
- Healthy People/Healthy Communities – improve the health of the population by supporting proven interventions that address behavioral, social and environmental determinants of health.
- Affordable Care – reduce the cost of quality healthcare.
Six priorities were developed to advance
these aims:
- Making care safer by reducing harm caused by delivery of care.
- Ensuring that each person and family is engaged as partners in their care.
- Promoting effective communication and coordination of care.
- Promoting the most effective prevention and treatment practices for the leading causes of mortality.
- Working with communities to promote wide use of best practices to enable healthy living.
- Making quality care more affordable.
Improving
health and health care quality can only occur if all sectors – individuals,
family members, payers, providers, employers and communities make it their
mission. Members of the healthcare
community can align to the National Quality Strategy by using the levers.
These levers represent core business functions, resources or actions
that can be taken by the stakeholder to align with this improvement
strategy. These levers are:
- Measurement and Feedback
- Public Reporting
- Learning and Technical Assistance
- Certification, Accreditation, and Regulation
- Consumer Incentives and Benefit Designs
- Payment
- Health Information Technology
- Innovation and Diffusion
- Workforce Development
For more
information check out the website www.ahrq.gov/workingforquality. This site shares examples of how
the priorities have been put into action and offers a great toolkit to assist
in your program development.
The CMS Innovation Center was created with the purpose of
testing innovative payment and service delivery models to reduce
expenditures. This program has the
following priorities:
- Testing new payment and service delivery models
- Evaluating test results and advancing best practices
- Engaging a broad range of stakeholders to develop additional models for testing
After a
rigorous evaluation of the impact of a model, feedback is provided in order to
foster continuous quality improvement.
The center leverages claim data
to deliver actionable feedback to providers about their performance and
encourages providers to use their own performance data to drive continual
improvement in their outcomes. Every
service delivery or payment model developed by the Innovation Center includes a
plan of action to ensure that lessons learned and best practices
identified during the test can be widely
disseminated, sharing the results
on an ongoing basis in order to promote rapid learning.
A great
website for additional information on this initiative is http://innovation.cms.gov/About/index.html.
The Transforming Clinical Practices Initiative
was designed to assist clinicians in achieving large-scale health
transformation and will impact practices over the next four years in sharing,
adapting and further developing comprehensive quality improvement strategies.
The goals are:
- Promoting broad payment and practice reform in primary care and specialty care
- Promoting care coordination between providers of services and suppliers
- Establishing community-based health teams to support chronic care management
- Promoting improved quality and reduced cost by developing a collaboration of institutions that support practice transformation.
The
Department of Health and Human Services will invest $840 million over the next four years. This will be a combination of incentives,
tools and information to encourage doctors to team with their peers and others
to move from volume-driven systems to value-based, patient centered,
coordinated healthcare.
As you can
readily see, all three of these initiatives have intertwining goals and
priorities – all of which pursue the ultimate goal of improving healthcare.
