Dear Reader

Prevention is a high priority for CMS. Medicare covers 18 preventive services that help older and disabled Americans stay healthy for as long as possible. As part of our obligation to protect beneficiaries, we have charged QIOs with increasing the number of people with Medicare who receive mammograms, colorectal screening tests, influenza immunizations, and pneumococcal pneumonia immunizations.

The QIO Program also incorporates essential work to slow the progression of disease. We have placed particular emphasis on reducing disparities in care and outcomes. QIOs in seven states, for example, are teaching diabetic self-management skills to African-American beneficiaries, whose rates of diabetic complications like kidney failure and vision loss are higher than those of other populations. In addition, all QIOs are expected to identify and address other disparities as they encounter them in the course of their improvement projects.

Finally, thanks to technical assistance from QIOs, hospitals nationwide have begun reporting Methicillin-resistant Staphylococcus aureus (MRSA) infections to the Centers for Disease Control and Prevention (CDC). These data are populating CDC’s National Healthcare Safety Network to provide an accurate picture of infection rates and patterns. Now QIOs are helping hospitals implement evidence-based practices for reducing MRSA and other Healthcare-Associated Infections (HAIs).

As these examples make clear, CMS’ commitment to prevention is ongoing. It seems especially timely, however, given the recent publication of the Agency for Health Research and Quality’s (AHRQ) National Healthcare Disparities and National Healthcare Quality reports for 2009. AHRQ found that preventive care is the most prevailing health disparity, progress in reducing HAIs is mixed, and much remains to be done before HAIs are eliminated.

Although these conclusions are disappointing, they are not surprising. Eliminating disparities and HAIs will take steady, sustained effort by every American health care provider and multiple government health agencies. As this issue’s article about HAIs illustrates, the QIO Program is expanding its partnerships, maximizing its impact, and pushing onward.

Barry M. Straube, M.D.
Centers for Medicare & Medicaid Services (CMS)
Chief Medical Officer and Director, Office of Clinical Standards and Quality