In my last post, I put forward some core “change principles” to guide our communities in working to transform the U.S. health care system. In this installment, I’ll try to apply those principles in recommending ways to enhance the value of the quality improvement work that HealthInsight and similar organizations perform for the Medicare program.
As the nation’s largest single purchaser of health care, the Centers for Medicare & Medicaid Services (CMS) has long been a pacesetter and incubator for change. The Quality Improvement Organization (QIO) program represents the largest sustained investment in large-scale quality improvement in history. HealthInsight has served as a contractor for this program since 1984, and our mission has evolved throughout the decades, at the leading edge of change in this national effort, to address changing goals, changing theories about what drives improvement, and changing models of care and care delivery support.
CMS is now designing its quality improvement initiatives for the Quality Innovation Network-QIOs (QIN-QIOs), spanning the 2019‒2024 contract period. These new initiatives give CMS a crucial opportunity to propel the health care system toward meaningful transformation.
At HealthInsight, we believe that sustainable quality gains and cost reductions will not occur without active participation from every segment of the health care system. Multiple stakeholders need to work together and employ diverse, but aligned, strategies and approaches to drive transformation.