primaris rural hit summit may 2010
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MO-10-04-HOSP -GEN May 2010This material was prepared by Primaris, the Medicare Quality Improvement Organization for Missouri, 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
Dorothy Andrae, MHA, BSN, RN, CPHQDirector, Clinical Review and Pt. Safety, Hospital
Rural HIT SummitMay 2010
Primaris
Who is Primaris?Healthcare consulting firm
Works with hospitals, physicians, nursing homes, health plans, and home health agencies
URAC accredited
Holds Medicare quality improvement organization (QIO) contract for Missouri
Missouri’s QIOMedicare population
Confidential
Information statutorily protected
Past, Present, and FuturePast
– History
– SOWs – 3 year cycles
– Evolution – less oversight, more consulting
Present
– 9SOW to December 2010
– Work with Identified Participant (IP) Providers
Future
– Transition to 10th SOW and beyond
The 9SOWAugust 2008 – July 2011
Theme-oriented (not setting oriented)
Work with Providers:
– Focus on facilities with the greatest opportunity for improvement
– Continue to provide assistance and resources to other providers as needed
9SOW FocusFour Themes:
– Prevention
– Beneficiary Protection
– Patient Safety
– Care Transitions
PreventionGoal to prevent and/or slow disease progression
Increase effective use of EHR/technology
Focus on screening:
– Colorectal Cancer, Mammography
– Influenza and Pneumococcal vaccination
Three areas of focus:
– Core measures
– Chronic kidney disease
– Disparities
Beneficiary Protection TasksGoal to protect the rights and health of Medicare beneficiaries
– Case Reviews – Medical Record reviews for quality
– Quality Improvement Activities (QIAs)
– Alternative Dispute Resolution (ADR)
– Sanction Activities
– Physician Acknowledgement Monitoring
– Maintain a beneficiary hotline
Quality Data Reporting **
Goal to reduce or prevent patient harm
Work focused in hospital and nursing home settings
Topics include:
– Physical restraints
– Pressure ulcers
– Surgical safety/heart failure
– Drug safety
– MRSA
– Technical assistance to NHs in need
Patient Safety
Patient SafetyWork focused in hospital and nursing home settings
Pressure Ulcer
What happens when you link hospitals and NH together?
– Prevention and treatment
– Cross setting collaboration
– What happens when you link hospitals and NH together?
www.primaris.org
800-735-6776 ext. 209
or
816-305-6523
Questions?