Quality Insights News 

On June 1, 2016, Sven Berg, MD, MPH, CPE, FAAP, Chief Medical Officer for Quality Insights Quality Innovation Network and Keith T. Kanel, MD, MHCM, FACP, Chief Medical Officer for Pittsburgh Regional Health Initiative (PRHI), served on a panel of experts that discussed successful partnerships at the annual meeting for the American Health Quality Association (AHQA) in Baltimore, Maryland.

Statistics show that 76 percent of hospital readmissions can be prevented


The Centers for Medicare & Medicaid Services’ (CMS) recently released the 2015 Quality Improvement Organization (QIO) Program Progress Report, which highlights how Quality Innovation Network-QIOs (QIN-QIOs) nationwide are bringing together local providers, partners and other stakeholders to achieve bold goals in health care quality improvement. 

April is National Minority Health Month

Thanks to tools provided by the Affordable Care Act, an estimated 30 percent of Medicare payments are now tied to alternative payment models that reward the quality of care over quantity of services provided to beneficiaries, HHS announced today.  Today’s announcement means that over 10 million Medicare patients are getting improved quality of care by having more time with their doctors and better coordinated care – nearly a year ahead of schedule.

Patient Safety & Quality Healthcare (PSQG) recently posted an article about nominations for a Sherman Award in Patient Engagement: “EngagingPatients.org, an online community dedicated to sharing best practices in patient and family engagement, is now accepting nominations for the 2016 John Q. Sherman Award for Excellence in Patient Engagement.


On December 28, 2015, President Obama signed into law the Patient Access and Medicare Protection Act. The law states that the Center for Medicare and Medicaid Services (CMS) will approve hardship exception applications submitted by eligible professionals, hospitals, and critical access hospitals that did not meet Meaningful Use in 2015.


The Centers for Medicare and Medicaid Services has issued a Notice of Proposed Rulemaking to revise the discharge planning requirements that Hospitals, including Long-Term Care Hospitals and Inpatient Rehabilitation Facilities, Critical Access Hospitals, and Home Health Agencies must meet in order to participate in the Medicare and Medicaid programs.


Dates: The call for Public Comment period opens on November 2 and closes on November 16, 2015

On September 28, 2015, CMS made available the 2014 Supplemental Quality and Resource Use Reports (QRURs) to every medical group practice and solo practitioner nationwide. Medical group practices and solo practitioners are identified in the Supplemental QRURs by their Taxpayer Identification Number (TIN). The Supplemental QRURs are also available for medical group practices and solo practitioners that participated in the Medicare Shared Savings Program, the Pioneer ACO Model, or the Comprehensive Primary Care initiative in 2014, in addition to those consisting of non-physician eligible professional (EPs).  

This October 5 - 9, Quality Insights is proud to support National Health IT Week.  National Health IT Week is the premier event offering all healthcare stakeholders an opportunity to unite under one banner, expressing the benefits that health information technology (IT) brings to U.S. healthcare. “One Voice, One Vision.”

On September 11, 2015, CMS began distributing letters to Physician Quality Reporting System (PQRS) individual eligible professionals (EPs), EPs providing services at a Critical Access Hospital (CAH) billing under method II, and group practices regarding the 2016 PQRS negative payment adjustment. The letter indicates that either an individual EP, EPs providing services at a CAH billing under method II, or the group practices that registered for the 2014 PQRS group practice reporting option (GPRO) did not satisfactorily report 2014 PQRS quality measures in order to avoid the 2016 negative PQRS payment adjustment and, therefore, all of their 2016 Medicare Part B Physician Fee Schedule (MPFS) payment will be subject to a 2.0 percent reduction.

In 2016, CMS will apply a negative payment adjustment to individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites and group practices participating in the Physician Quality Reporting System (PQRS) group practice reporting option (GPRO) (including Accountable Care Organizations [ACOs]) that did not satisfactorily report PQRS in 2014. Individuals and groups that receive the 2016 negative payment adjustment will not receive a 2014 PQRS incentive payment.

More than 1,900 providers and 300 community partners are collaborating for better health, better care and lower costs.

CMS may begin using PECOS account information for upcoming communications

The Centers for Medicare & Medicaid Services (CMS) will host a series of webinars to discuss The QIO Program in Action: National Benefits, Local Support

Secondhand smoke causes cancer and other diseases in non-smokers

As of August 1, 2015 the calls to any of Quality Insights' toll-free numbers for appeals and quality of care (QOC) concerns will no longer be forwarded to the Beneficiary & Family Centered Care-Quality Improvement Organizations (BFCC-QIO).  Additionally, the toll-free numbers that were in effect prior to August 1, 2014 for appeals/QOC concerns, will no longer work starting August 1, 2015.   

A video recording of the "PQRS/Value-Based Provider Modifier: What Medicare Professionals Need to Know in 2015" presentation has been posted to the CMS MLN Connects® page on YouTube.  This presentation is the same as the webinars that were delivered on March 31, 2015 and April 7, 2015.

In recognition of National Nursing Home Week, May 10-16, QIO News is helping highlight how the QIO Program and its national and community partners are striving to instill quality performance and improvement practices in nursing homes across the country.

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