Acumentra Health will continue to lead healthcare quality improvement initiatives for the Medicare program in Oregon under a five-year contract awarded to HealthInsight, Inc., by the Centers for Medicare & Medicaid Services (CMS).
Acumentra Health has served as Oregon’s Medicare Quality Improvement Organization (QIO) continuously since 1984. On August 1, 2014, Utah-based HealthInsight will become the Quality Improvement Network-QIO (QIN-QIO) for Oregon and three other states, for a contract term extending through July 2019. In its most recent Request for Proposals to perform this work, CMS required that each bidder’s proposal cover at least three states to a maximum of six states, rather than a single state as in the past.
As the QIN-QIO’s Oregon-based subcontractor, Acumentra Health will continue to work with Oregon healthcare providers to promote patient-centered care, make care safer and more affordable, and improve population health. The company will engage hospitals, nursing facilities, physician practices, and Medicare beneficiaries throughout the state to develop and apply proven strategies for delivering safer, more efficient care.
“We are proud of the real, measurable improvements in care made by the providers that have taken part in our Medicare initiatives over the years,” said Jon K. Mitchell, president and CEO of Acumentra Health. “Our past and future working relationship with HealthInsightensures that we can continue to make a positive impact on the health of Medicare beneficiaries in Oregon and in all states withinHealthInsight’s service area.”
Marc Bennett, president and CEO of HealthInsight, commented: “Acumentra Health’s strength and experience will be a critical part of our Medicare QIN-QIO success over the next five years. We are excited about the opportunity to work together to continue to improve health and health care in Oregon through this program.
The major strategic aims of the upcoming five-year work program for CMS include:
Healthy People, Healthy Communities: Promote effective prevention and treatment of chronic disease, a major driver of Medicare costs, by:
· improving cardiac population health and reducing disparities in care for heart attack and stroke;
· reducing disparities in diabetes care by improving self-management skills among members of targeted beneficiary populations; and
· helping providers use electronic health record (EHR) technology to improve the coordination of preventive care, such as immunizations and screening.
Better Health Care for Communities: Make care safer by reducing harm caused in the delivery of care, and promote effective coordination of care. Tasks include:
· reducing health care-associated infections in hospitals;
· reducing health care-acquired conditions (such as pressure ulcers and the consequences of patient falls) in nursing homes; and
· improving coordination of care for Medicare patients across health care settings, with emphasis on reducing hospital admissions and readmission rates and preventing adverse drug events, a leading cause of preventable patient harm.
Better Care at Lower Cost: This aim dovetails with CMS’s program to encourage quality improvement through value-based payment of providers, quality data reporting, and the Physician Feedback Program. Acumentra Health will support hospitals, physician practices, and other providers in reporting quality data electronically and in developing the capacity to use their own data to improve care processes.
To meet program goals, Acumentra Health will engage Medicare beneficiaries and their family members and representatives as active partners in the beneficiary’s health and plan of care.
Due to changes made by CMS in Medicare program rules, Acumentra Health can no longer perform medical case review to investigate Medicare beneficiaries’ concerns about the quality of their medical care and about the duration of skilled healthcare services they receive. CMS has assigned that task to Livanta LLC as the new Beneficiary and Family-Centered Care QIO serving Oregon. Effective August 1, 2014, Medicare beneficiaries who have concerns about the quality of medical care they receive from Oregon providers should call Livanta at 1-877-588-1123.
