| AZ Annual Medical Services Review Report | |
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Summer 2011 Arizona Edition: Volume 2, Issue 2 |
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 New CMS Quality Improvement Projects to Begin August 1
The Centers for Medicare & Medicaid Services (CMS) utilizes its network of state-based Quality Improvement Organizations (QIOs—HSAG is the QIO for Arizona) to protect Medicare beneficiaries, assist health care providers, and improve the U.S. health care system. It does this through the implementation of three-year cycles of work that define specific national health care quality improvement projects that the QIO network implements at the local level. A new cycle (the 10th Scope of Work) begins August 1, 2011.
The 10th Scope of Work is in alignment with the recently developed U.S. Department of Health and Human Services (HHS) National Strategy for Quality Improvement in Health Care (National Quality Strategy), which has three broad aims of (1) better health care, (2) better health for people and communities, and (3) affordable care through lowering cost by improvement. QIOs will assist local health care providers to improve in the following areas:
- Hospitals—Reducing Healthcare-Associated Infections
- Central-Line Associated Bloodstream Infections (CLABSIs)
- Catheter-Associated Urinary Tract Infections (CAUTIs)
- Surgical Site Infections (SSIs)
- Clostridium Difficile Infections (CDIs)
- Nursing Homes—Reducing Healthcare-Acquired Conditions
- Pressure Ulcers
- Physical Restraints
- CAUTIs
- Falls
- Physician Offices—Using Electronic Health Records to Improve Primary Care Prevention and Early Diagnosis
- Flu and Pneumonia Immunization
- Breast and Colorectal Cancer Screening
- Ischemic Vascular Disease
- All Providers—Reducing Adverse Drug Events and Implementing Patient-Centered Care
- All Providers—Improving Care Transitions
Beginning in August, HSAG will invite local providers to participate in the above-named quality improvement activities. At that time, more information will be available at www.hsag.com.
For more about the CMS QIO program, visit http://www.cms.gov/QualityImprovementOrgs.
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HSAG Hosts CMS-SSA Congressional Seminar/PCIP Webinar
HSAG hosted the Centers for Medicare & Medicaid Services (CMS) and Social Security Administration (SSA) Congressional seminar in Phoenix on June 21, 2011. The meeting, held every two years, brings together Congressional, CMS, and SSA staff to provide updated information related to Medicare and Social Security policies and benefits changes. The meeting also provided a platform to air any constituent or policy concerns. Approximately 40 attendees—consisting of 25 Congressional staffers (at least one representative from every Congressional office in Arizona), several SSA and CMS representatives, and four HSAG employees—made this year’s meeting attendance the highest since HSAG began hosting the event.
Peter Bauer, CMS Health Insurance Specialist, presented on Medicare coverage parts A, B, C, and D and discussed the importance of knowing when to file for benefits and the penalty for filing late. He also reviewed Medicare coverage for hospitals, skilled nursing homes, home health agencies, hospice services, and prescription drug plans.
Lowell Kepke, Deputy Regional Communications Director for SSA, presented a review of e-services and e-Congressional options that Congressional staffers can use to expedite constituent claims, as well as program changes with new rules and regulations, program updates highlighting the latest on the key programs and initiatives, and updates on the hearing process.
David Sayen, CMS Regional Administrator, conducted a Webinar presentation for Arizona health care consumers, providers, and stakeholders on the Affordable Care Act and the Pre-Existing Condition Insurance Plan (PCIP). The Webinar provided information on Web-based consumer resources, as well as PCIP statutory authority, eligibility, coverage application, comprehensive benefits, and important features. The recorded Webinar can be accessed at http://www.hsag.com/events/consumer.aspx.
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 HHS Unveils Interactive Video to Prevent HAIs
The U.S. Department of Health & Human Services (HHS) recently launched a training video, Partnering to Heal, which allows viewers to "become" one of five characters who can make decisions that impact health risks, view the results of those decisions, and learn from the outcomes. Available online at no cost, the training video promotes a team-based approach to reducing preventable infections and deaths.
This six-minute video can be used to reinforce the ease at which healthcare-associated infections (HAIs) are spread throughout health care settings. The video can also be used to start discussions about HAI rates in your organization and to serve as a group or individual training tool. To view the video and other related resources, visit http://www.hhs.gov/ash/initiatives/hai/training.
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On the CUSP
The Centers for Disease Control and Prevention estimates that over 2 million HAIs occur in U.S. hospitals each year, and as many as 99,000 patients who get these infections die as a result. These infections also result in $4.5 billion in excess health care costs annually.
Through September 2012, the Agency for Healthcare Research and Quality and other partners will implement an educational and technical initiative using the Comprehensive Unit-based Safety Program (CUSP) and interventions designed to prevent central-line-associated blood stream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). CUSP was designed to improve safety culture and help clinical teams learn from mistakes by integrating safety practices into the daily work of a unit or clinical area.
In 2003, the Michigan Hospital Keystone Project partnered with Johns Hopkins University Quality and Safety Group to help 127 Michigan ICUs implement CUSP to reduce CLABSI. Within 18 months, the participating sites successfully reduced the CLABSI rate to a median of zero, saving an estimated 1,500 lives and $200 million annually. Those rates have now been sustained for nearly five years. In Arizona, nine hospitals are participating in the national On the Cusp Project through coordination with the Arizona Hospital and Healthcare Association.
To read more about CUSP, visit http://www.onthecuspstophai.org.
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Hospital Events and Resources
- A recording and handouts for the July 14 Webinar, "CLABSI Reporting Through NHSN—Tips, Tricks, and Best Practices," presented by the CDC’s Katherine Allen-Bridson, are available at http://www.hsag.com/azhospitals/mrsa/events.aspx.
- Fiscal Year 2012 Structural Measures and Data Accuracy and Completeness Acknowledgement requirements are due August 15, 2011 (available from July 1–August 15, 2011).
- Q1 2011 Population and Sampling is due August 1, 2011.
- Q1 2011 Inpatient Clinical Data Submission is due August 15, 2011.
HSAG provides all Arizona hospitals with notifications and reminders—with detailed instructions—for each of these Centers for Medicare & Medicaid Services (CMS) requirements. For questions or assistance, please contact Suzette Gerhart at sgerhart@azqio.sdps.org or at 602.801.6915.
For more information on HSAG's hospital initiatives, visit:
http://www.hsag.com/azhospitals/default.aspx. | |
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 Advancing Excellence Campaign—Consistent Assignment
Consistent assignment is one of eight goals identified by Advancing Excellence in America’s Nursing Homes, a national campaign designed to improve the quality of care delivered to nursing home residents. The Campaign Web site contains various resources and information on the benefits of consistent assignment to help nursing homes maximize quality, as well as improve resident and staff relationships. Resources include the following:
- Implementation guides
- Journal articles
- Consistent assignment calculation tools
- Recorded WebEx events on the implementation tools
- Consumer and nursing home staff fact sheets
- Videos on where to start and how to implement consistent assignment
For more information and to download resources and information, click here.
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Behavioral Health Licensure Rulemaking
On April 13, 2011, Governor Brewer signed HB2634, which requires the Arizona Department of Health Services (ADHS) to revise rules to reduce costs and streamline the regulatory process for health care institutions, including those providing behavioral health services. The new law also requires ADHS to "facilitate licensure of integrated health programs that provide both behavioral and physical health services."
As part of implementing HB2634, ADHS is reviewing all of the rules regulating the licensure of health care institutions—including those providing behavioral health services—and is considering the current structure and functions of health care institutions, the licensing requirements for facilities, and the types of services provided at different types of health care institutions. To assist ADHS in focusing the changes to be made in the new rules, input is needed from stakeholders. Stakeholders can describe their experiences, issues and challenges imposed by the current rules, and where the current rules are regulating health care institutions effectively. ADHS will use a stakeholder survey to collect these comments now through August 1.
For updated information on rule making and to comment on SB 2654, visit http://www.azdhs.gov/diro/admin_rules/behavioralhealth.htm.
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 New, Shorter Version of CRC Screening Clinician's Toolbox and Guide Available
A new, shorter version of the Colorectal Cancer (CRC) Screening Clinician’s Toolbox and Guide is now available. The most important material from the full Guide was condensed into a step-by-step tool that still offers an expansive collection of the most relevant charts, templates, and sample materials that clinicians can put to use. View the Guide by visiting http://nccrt.org/about/provider-education/crc-clinician-guide.
For a copy of the presentation that accompanies the Guide, visit http://nccrt.org/wp-content/uploads/CancerScreeningActionPlan.pdf.
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Medicare Beneficiaries Not Taking Full Advantage of Preventive Services
As part of the new federal health care law, Medicare beneficiaries have access to more than a dozen free tests and other services to prevent or control cancer and other debilitating diseases, but many are not taking advantage of preventive services such as mammograms or colonoscopies. Download the Medicare & You Handbook, which includes a list of preventive services that are now free.
For more information, visit http://tinyurl.com/647sbku.
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CMS Announces First Medicare EHR Incentive Payments
On May 19, 2011, the Medicare Electronic Health Record (EHR) Incentive Program issued the first round of payments totaling $75 million to providers who signed up in the first two weeks of the program. The Centers for Medicare & Medicaid Services (CMS) expects that providers will attest throughout 2011 and that the total amount of Medicare EHR incentive payments will continue to grow. For more information on the Medicare and Medicaid EHR Incentive Programs, visit http://www.cms.gov/ehrincentiveprograms.
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CMS Announces Proposed Rule for the Electronic Prescribing (eRx) Incentive Program
CMS has proposed changes to the Medicare eRx Incentive Program due to requests to better align the Program with the Medicare and Medicaid EHR Incentive Programs.
The CMS proposed eRx rule may be viewed at http://www.gpo.gov/fdsys/pkg/FR-2011-06-01/pdf/2011-13463.pdf.
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 OIG Work Plan
The Office of Inspector General (OIG) Work Plan for Fiscal Year 2011 provides descriptions of activities that the OIG plans to initiate or continue with respect to programs and operations of the Department of Health and Human Services in fiscal year 2011. The body of the Work Plan is presented in seven major parts followed by Appendix A, which describes the OIG’s oversight and funding that HHS receives under the American Recovery and Reinvestment Act of 2009. The seven major parts of the Work Plan include:
- Medicare Part A and Part B.
- Medicare Part C and Part D.
- Medicaid Reviews.
- Legal and Investigative Activities.
- Public Health Reviews.
- Human Services Reviews.
- Department-Wide Issues.
For more information, visit http://oig.hhs.gov/publications/workplan/2011/.
To dowload the entire OIG Work Plan for Fiscal Year 2011, visit http://oig.hhs.gov/publications/workplan/2011/FY11_WorkPlan-All.pdf. |
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 FDA Reports Medication Errors Involving Requip and Risperdal
The Food and Drug Administration (FDA) has issued an alert on medication errors for patients who were given the antipsychotic risperidone (brand name Risperdal), instead of ropinirole (Requip), which is used to treat Parkinson’s disease and restless legs syndrome, or vice versa.
Some patients who took the wrong medication were hospitalized with symptoms that included confusion, lethargy, hallucinations, tiredness, dizziness, tingling, numbness, and altered mental status.
The FDA is asking medication manufacturers to take the following measures to reduce the potential for confusion between the two products:
- Use of "tall man" lettering on container labels and carton packaging to present the generic names as risperiDONE and rOPINIRole
- Changing labels and carton packaging to provide better differentiation between the products
To learn more, click here.
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HSAG Contacts
Hospitals and Drug Safety:
Charlie Chapin, MS, CHCA, Director, Decision Support, 602.801.6940
Nursing Homes:
Joe Bestic, NHA, BA, Director, Nursing Home, 602.801.6930
Physician Offices:
Padma Taggarse, MS MI, Director, Physician Office Quality, 602.614.8942
Case Review:
Suzanne Powell, RN, MBA, CPHQ, CCM, Director, Quality Improvement, 602.801.6902
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We welcome your feedback! Please e-mail: lcooper@hsag.com
This material was prepared by Health Services Advisory Group, Inc., the Medicare Quality Improvement Organization for Arizona, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. AZ-9SOW-XC-072711-01.
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