The Centers for Medicare and Medicaid Services (CMS) has taken another step toward ensuring that beneficiaries receive better care, better health and greater value by awarding 16, two-year Special Innovation Projects (SIPs), to 10 regional Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs). The SIPs address healthcare quality issues such as early detection and management of sepsis, advance care planning, colorectal cancer screening, and disease management in rural settings among other critically important healthcare quality issues. The list of 2015 SIPs can be found on the Quality Improvement Organization Program website (http://qioprogram.org/cms-awards-16-partnership-driven-special-innovation-projects-10-qin-qios).
While it is not the first year of the QIN-QIO contracts, the 2015 SIP awards represent a paradigm shift in how CMS views and utilizes the investment made in special quality innovation work. We recognize that there is tremendous quality work occurring in the field, and by requiring that the QIN-QIOs partner with organizations (Federal, State, local community, and/or Private), we can potentially capitalize on interventions that have not made it into mainstream use.
The SIE is a new endeavor aimed at advancing CMS’ six quality strategy goals (https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/CMS-Quality-Strategy.html) by rapidly moving innovative, evidence-based quality practices from research to implementation through the QIO Program and the Medicare program, with the effects spreading throughout the greater healthcare community. The SIE will accomplish this by:
- Identifying gaps in the quality improvement agenda and recognizing potential innovations through a continuous scan of the quality environment while creating the opportunity for frontline healthcare providers to put forth evidence-based practices for consideration by the SIE;
- Problem solving, proposing new areas for evidence development in the science of quality improvement, and considering how to rapidly move the nation from best practice to common practice in key healthcare areas; and
- Working, in conjunction with the QIN-QIOs and their many partners, to purposefully spread evidence-based practices throughout the Medicare program, using multiple channels such as the QIO Program, CMS stakeholder partners, and others, to ultimately provide practical implementation strategies and methods for frontline providers to integrate high impact, high value best practices into their work to ensure patients receive the right care, at the right time, every time.
QIN-QIOs were eligible to submit proposals for two types of Special Innovation Projects in 2015:
- Projects addressing issues of quality occurring within the QIN-QIOs’ local service area: “Innovations that Advance Local Efforts for Better Care at Lower Cost.”
- Projects focusing on expanding the scope and national impact of quality improvement interventions that have had proven, but limited success: “Interventions that are Ripe for Spread and Scalability.” QIN-QIOs were encouraged to propose interventions intended to reduce mortality, harm, healthcare disparities and costs; provide higher return on investment; link value with quality; and encourage utilization of alternative payment models by providers.
CMS sought proposals with scientific rigor, a strong analytic framework and a reasonable, proposed intervention based on the supporting evidence provided. Additionally, CMS looked for evidence of QIN-QIO partnerships at the community, regional and national levels, and direct links to the CMS Quality Strategy goals.
This program demonstrates CMS’ commitment to partner and collaborate with organizations, providers, and people across the country to achieve better care, smarter spending, and healthier people.