CMS HDQIOSC

Situation

The Office of Clinical Standards and Quality (OCSQ), Centers for Medicare & Medicaid Services (CMS) oversees the quality of healthcare for Medicare beneficiaries through its Quality Improvement Organization (QIO) program. The issue of health disparities was integrated throughout all of the QIO Program's 9th Statement of Work (SOW) Tasks and Sub-national Task areas: Beneficiary Protection, Patient Safety, Prevention (Core), Prevention (Disparities), Care Transitions, and Prevention (Chronic Kidney Disease). To facilitate such an effort, CMS contracted with HCD International to serve as the Health Disparities Quality Improvement Organization Support Center (HDQIOSC) contractor to focus on health disparities reporting and analysis, developing culturally appropriate materials, and state and regional public health campaign development on the 9th SOW Themes and Sub-National Task areas.

Task

HCD International was required to receive CMS claims data from CMS, QIOs, and other data contractors to efficiently provide analysis and reporting to QIOs on a weekly, monthly, and quarterly basis to provide health disparities analysis and reporting as related to clinical outcome measures (aggregate statewide diabetes rates, Patient Activation survey data collection and analysis, patient level nursing home data, business case analysis and utilization analysis based upon CMS claims data). In addition, HCD International would need to provide statistical methodology technical assistance, outreach and marketing, materials development, and strategic interventions for provider and Medicare beneficiary recruitment and retention.

Action

The HDQIOSC provided quality data analysis and reports to all 53 QIOs and CMS leadership on each theme and sub-national task (aggregate statewide diabetes rates, Patient Activation survey data collection and analysis, patient level nursing home data, business case analysis and utilization analysis based upon CMS claims data). The state level health disparity analysis and reporting provided to each QIO for their respective Theme and/or sub-national task aided them in intervention implementation and programmatic planning. In addition, HCD International provided a plethora of support to CMS and the National Institute on Minority Health and Health Disparities to plan and coordinate national meetings with key stakeholders and subject matter experts, write ad hoc reports, write articles for publication, and present at national and local conferences.

Result

HCD International's performance enabled CMS to exercise all option years of the contract and additional modifications to the contract for new components, such as the ability to construct and launch the CMSPULSE.org website, the Mississippi Health First diabetes initiative, and work with three major learning institutions to create evidence based tables to be used for future OCSQ clinical quality improvement initiatives