Quality Talk
Quality Talk
Michelle Snyder, CMS deputy chief operating officer and acting principal deputy administrator, is responsible for the coordination, integration and execution of policies and activities across CMS, including new program initiatives. Most recently, in her role as acting deputy administrator for CMS, Michelle fostered collaboration among CMS leadership to ensure that the strategic goals and initiatives of CMS were implemented and managed successfully. Formerly, she was the director of the Office of Financial Management and the Agency's first chief financial officer. Under her leadership, CMS developed its first comprehensive strategic plan on program integrity. Snyder holds advanced degrees in clinical psychology and legal studies and administration and has received numerous awards and honors, including the Presidential Meritorious Service Award.
“In moving towards an environment where quality and performance data drives decisions, we are mindful of our important responsibility to protect beneficiaries against disclosure of sensitive health information.”How does the Medicare QIO Program help to transform and modernize the health care system? What metrics are in place to measure success?
The QIO Program framework is based on measurable, specific performance metrics designed to drive improvement and evaluate the value of QIO interventions. These initiatives are critical to transforming and modernizing the health care system because they will allow us to better collect, integrate and utilize health care data to identify areas in need of performance improvement and also to measure our progress. Through the QIO Program, CMS is measuring improvements in increasing vaccination rates, reducing Healthcare-Associated Infections (HAIs), reducing unnecessary re-hospitalizations, and other system-wide changes that increase the quality of care.
In 2003, Congress required CMS to implement a series of quality reporting initiatives for hospital settings. What programs has CMS implemented to satisfy this requirement?
Apart from the QIO Program 9th Statement of Work, CMS has implemented other initiatives reliant on performance information including the Nursing Home Quality Initiative, hospital quality reporting and the Physician Quality Reporting Initiative (PQRI).
An outgrowth of these statutory requirements is the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) initiative, which requires hospitals to report quality data to CMS to receive a full payment update, and the Hospital Compare website (http://www.hospitalcompare.hhs.gov/), which allows the public to view quality comparisons between hospitals. Over time, CMS has increased the number of measures for both programs; for instance, RHQDAPU will have 43 measures in FY 2010, up from 10 measures in FY 2006. We’ve also recently updated hospital readmission and mortality rates and added hospital outpatient department data on the Hospital Compare website.
As a result of these programs, we’ve begun to see improvement in the results of the hospitals, including a decrease in the percentage of surgical patients receiving incorrect surgical care antibiotics, which reduces mortality, morbidity and re-hospitalization rates.
How is CMS applying funds provided by the Recovery Act to support the adoption of health IT and encourage the use of Electronic Health Records?
CMS is directing resources provided by the Recovery Act to incentivize Medicare providers to adopt health IT. CMS is also working to advance wellness and prevention by helping reduce the incidence of HAIs, a top priority for the U.S. Department of Health and Human Services. In addition, CMS has designated a Project Management Office to manage and monitor the implementation of the Recovery Act to ensure that the Department has timely information to work with us on the implementation of this key legislation.
What are some of CMS’ challenges as you continue to increase the use of performance information to improve health care quality in the future?
In moving towards an environment where quality and performance data drive decisions, we are mindful of our important responsibility to protect beneficiaries against disclosure of sensitive health information. CMS is balancing the goal of promoting research-driven results and increased transparency with the commitment to do so within existing beneficiary privacy protections. The Agency is committed to continual improvement and strives to ensure that we provide the highest quality of services to the more than 98 million Americans who rely on our programs for their health care needs.
The recently released 2009 National Healthcare Disparities Report and the National Healthcare Quality Report indicated that Healthcare-Associated Infections (HAIs) increased and minorities were less likely to have insurance and less likely to get the treatments they needed. Do you think that health care reform will have a positive impact on reducing HAIs and improving health care quality?
Yes, and I believe Secretary Kathleen Sebelius’ recent statement regarding the reports addresses this issue best. She said, “In a reformed system, more Americans will get the care they need, regardless of their race or ethnicity and the quality of care will improve…Under health care reform, families have a guaranteed choice of quality, affordable health insurance if they lose their jobs, switch jobs, move or become sick.”
CMS is pleased with the progress we have made in our efforts to improve the quality of care for millions of Americans. I am confident that our journey in using performance information effectively to reduce HAIs and improve health care quality for all CMS beneficiaries will serve us well as we extend this care to the millions of Americans who will now be eligible for CMS benefits under the new health reform.
