As nursing homes are pushed to improve quality, a major resource has had to pause due to a lack of a new contract.
The American Health Quality Association, which represents 13 quality improvement organizations, said that as of last Thursday, it was facing a lapse of up to four months in the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) program. The $960 million contract for the program will not be renewed until this fall, Modern Healthcare reported, which has led to rounds of layoffs and programs being paused.
The QIO program is a mandatory federal program. The association has touted its members “incredible progress,” including reduction of hospital readmissions and better nursing home care. In one case study, the New England Quality Innovation Network-Quality Improvement Organization focused on special training program for nursing homes with high rates of residents with psychiatric diagnoses who were under age 65. Others have successfully helped reduce antipsychotic use in nursing homes.
The Centers for Medicare & Medicaid Services first notified quality contractors in a June 26 notice. Since July 17, the QIN-QIO program has “ceased to provide quality improvement technical support to Medicare participating hospitals, doctors and post-acute care facilities,” the head of the AHQA said.
“This is the most existential crisis that the QIN-QIO infrastructure has faced since its inception,” said Alison Teitelbaum, executive director of AHQA. “The loss of key personnel and subsequent dismantling of the Quality Improvement infrastructure is detrimental to Medicare beneficiaries and the providers that care for them. CMS has spent the last 30 years building up the most innovative and valued quality improvement system across the entire federal government, and it is now letting that program atrophy.”
CMS ordered all referred casework from Medicare beneficiary quality complaints to stop as of July 17.
The agency told Modern Healthcare it was in the process of transitioning to a new contract.
But the several months of lag time means many providers with years of experience will have to find new jobs.
AHQA said CMS should prioritize the award of the next five-year statement of work for the QIN-QIO program and allow providers to re-start immediately.
