HSAG Accomplishments:
Successful Medicare Contract,
High Marks from Stakeholders

Health Services Advisory Group has passed its final federal evaluation under its current three-year contract to help providers improve Medicare beneficiaries' quality of care, and it has earned some of the highest satisfaction scores in the nation from the stakeholders and providers it works with in Arizona.

The final evaluation under HSAG's 8th Scope of Work (SoW) contract showed that for eight tasks—or settings of care—the company received five excellent-pass scores, two full-pass scores, and one conditional-pass score, all of which amounted to a successful completion of the contract.

Part of the 8SoW included a survey of providers and stakeholders who worked with the QIO to improve care among Medicare beneficiaries. The three survey categories included knowledge, value, and overall satisfaction with the QIO. HSAG scored first in the nation in knowledge, fifth in value, and fifth in satisfaction, with an overall score that placed the company second in the nation among all QIOs. By settings of care, HSAG scored first under the Nursing Home task, sixth under the Hospital task, and eighth under the Physician Practice task.

Quality improvement organizations (QIOs) such as HSAG work to help improve Medicare beneficiary health under federal "Scope of Work" contracts that typically last for three years. The current contract, Medicare's eighth, began in November 2005. The focus is quality improvement work that results in care that is safe, effective, patient-centered, timely, efficient, and equitable—summed up by the Centers for Medicare & Medicaid Services as "the right care for every person every time."

Under this latest contract, HSAG received excellent scores for its work under settings of care designated as Hospital, Physician Practice, Underserved Populations, Beneficiary Protection, and Hospital Payment Monitoring. The Nursing Home and Critical Access Hospital/Rural Hospital settings received full-pass scores, and the Home Health setting received a conditional pass. Home health was among the most challenging settings for many QIOs across all states. Seven states received conditional passes for home health—the most of any task—and four failed the task altogether.

States that passed the final evaluation (like Arizona did) received automatic renewal of core contract work for the 9SoW period beginning next August. Core contracts in states that failed any one of the tasks may now be open for rebidding. Nine states had one or more task failures.

"The successful completion of our 8th Scope of Work contract and the high satisfaction scores we received from our providers and stakeholders all show that HSAG is performing well and is communicating effectively to maintain the contract that provides quality oversight for Medicare beneficiaries in Arizona," said Mary Ellen Dalton, chief executive officer of HSAG. "The QIO program in general serves as a highly valuable component of the health care system in this country."

Moving forward under the 9SoW, QIOs will continue efforts to improve beneficiary health by focusing on beneficiary protection, patient safety, and prevention, all of which will be part of the new core contract. QIOs can compete for additional contract work for special projects such as Patient Pathways (Care Transitions) and Chronic Kidney Disease.