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Spotlight summarizes recent activities, publications, and findings that contribute to the advancement of Medicaid quality. Webcast Availability for the National Medicaid Dental Town Hall Forum Materials Available for the National Medicaid Dental Town Hall Forum Hospital Compare Adds Pediatric Asthma Measures National Dental Summary 2008 CMS Implements New Nursing Home Rating System NIH Issues Asthma Guidelines CMS Issues Eight Quality Assessment Reports during Fiscal Year 2008 Materials for Fall Quality Conference, November 1, 2007 ------------------------------------------------------------------------------------------------------------------------- Webcast Availability for the National Medicaid Dental Town Hall Forum The CMS National Medicaid Dental Town Hall Forum scheduled for April 6, 2009 from 1:00 – 5:00 pm is now available via a webcast for those unable to participate in person. Registration is required through the Maternal and Child Health Bureau of the Health Resources and Services Administration (HRSA) website. CMS appreciates HRSA's support in this project. Please register via the link ("Dental Town Hall Registration") given below. Materials Available for the National Medicaid Dental Town Hall Forum The Centers for Medicare & Medicaid Services (CMS) has posted additional information on the CMS website regarding the National Medicaid Dental Town Hall Forum scheduled for April 6, 2009 at the CMS complex in Woodlawn, MD (please see the link below.) Included are the agenda for the meeting, a discussion paper (including instructions for registering to comment in-person at the meeting) and security procedures to be followed in order to enter the CMS complex. We look forward to this valuable exchange of information and notable practices for improving the quality of dental care provided to children receiving Medicaid services. If you have registered for the meeting and are unable to attend, please let us know as soon as possible. CMS must be notified of any substitution of registrants by April 1st. Individuals whose names are not on the list of registrants provided to security personnel will not be allowed onto CMS property. PLEASE NOTE: THE FORUM HAS BEEN EXTENDED UNTIL 5:00 PM. Continue to check this website for additional information about the Forum. We continue to work toward availability of Webcast conferencing for those who are not able to attend in-person. Hospital Compare Adds Pediatric Asthma Measures On August 20, 2008 CMS announced that the agency's Hospital Compare consumer website had expanded the inpatient measures reported for hospitals across the country to include, for the first time, quality information based on hospitalizations of pediatric patients. The information contained on the Hospital Compare website is intended to provide consumers with another tool to use in making healthcare decisions and to and motivate providers to provide better quality care. Hospitals voluntarily give The Joint Commission permission to share with CMS the data needed to populate the Hospital Compare website. One of the two pediatric measures is the "Percent of Children Who Received Reliever Medication While Hospitalized for Asthma". Reliever medications relax the bands of muscle surrounding the airways in the severe phase of an asthma exacerbation and quickly make breathing easier. The other new pediatric measure is the "Percent of Children Who Received Systemic Corticosteroid Medication (oral and IV Medication That Reduces Inflammation and Controls Symptoms) While Hospitalized for Asthma". These medications are used to treat severe asthma by reducing inflammation and controlling allergic reactions. In addition to the two children's asthma care measures, Hospital Compare reports on 26 process of care measures, 2 outcome of care measures, and 10 patient experience of care measures. Hospital Compare also contains information about the number of certain elective hospital procedures provided to patients and what Medicare pays for those services.
A link to the Hospital Compare website are furnished below. National Dental Summary 2008 On January 15, 2009, CMS released a National Medicaid Dental Summary. In response to increased interest in access to oral health services for Medicaid eligible children, CMS performed 16 on-site State dental reviews from February to May 2008. The Summary is a compilation of those reports and includes information such as how the States were selected for review, who was interviewed during the reviews, general findings and recommendations made to States, and promising or notable practices discovered during the on-site reviews. The Summary also includes proposed oral health initiatives that CMS plans in follow-up to the reviews. The Summary is available at: the link below. CMS Implements New Nursing Home Rating System On December 18, 2008 CMS posted the quality ratings of 16,000 individual nursing homes on the Nursing Home Compare website (see link below). Partnering with other organizations seeking to advance quality improvement, CMS developed the Five-Star Quality Rating System to enhance transparency in the Medicare and Medicaid programs and provide consumer-friendly information to aid in the selection of a facility. Each nursing home receives a rating of one to five stars in each of three areas (i.e., health inspections, staffing, and quality measures). These three ratings are then combined to calculate an overall rating for each facility. The data upon which these ratings are calculated for individual nursing homes can be found on the Nursing Home Compare website. The health inspection data summarize recent patterns in deficiencies identified through nursing home surveys. The nursing home staffing data represent the average number of hours and minutes of care per day provided to each resident in the facility. The quality measures are derived from resident assessment data that nursing homes routinely collect on all residents at specified intervals during their stays. CMS recommends that consumers supplement these ratings with visits to nursing homes they are considering. NIH Issues Asthma Guidelines In December 2008, the National Institutes for Health (NIH) issued "Expert Panel 3 Report –Guidelines for the Diagnosis and Management of Asthma: Partners Putting Guidelines into Action". The Guidelines Implementation Panel Report was developed by a group of experts convened by the National Asthma Education and Prevention Program of NIH's National Heart, Lung, and Blood Institute. This report offers strategies for improving quality of care and outcomes for people who have asthma by closing the gap between scientific advances and their practical application in the field. The six priority messages articulated by the Panel are: 1. Inhaled corticosteroids…should be utilized by patients and clinicians for [long-term] control of [persistent] asthma. 2. All people who have asthma should receive a written asthma action plan to guide their self-management efforts. 3. All patients should have an initial severity assessment…to determine type and level of initial therapy needed. 4. At planned follow-up visits, asthma patients should review level of control with their health care provider…in order to guide clinician decisions to either maintain or adjust therapy. 5. Patients who have asthma should be scheduled for planned follow-up visits at periodic intervals in order to assess their asthma control and modify treatment if needed. 6. Clinicians should review each patient's exposure to allergens and irritants and provide a multi-pronged strategy to reduce exposure to those allergens and irritants…that make the patient's asthma worse. The full Panel Report is available at the link provided below. CMS Issues Eight Quality Assessment Reports during Fiscal Year 2008 The Centers for Medicare & Medicaid Services (CMS) is providing individual States with Quality Assessment Reports (QAR), comprehensive information about the status of access and quality and activities already underway to improve them under both managed care and fee-for-service delivery systems. Issuing such Reports supports States in their efforts to enhance the ability of Medicaid beneficiaries and Children's Health Insurance Program (CHIP) enrollees to obtain the highest quality healthcare services. By issuing QARs, the Centers for Medicare & Medicaid Services also demonstrates its effectiveness in supporting State administration of the Medicaid and CHIP programs. Under the terms of a long-term Government Performance and Results Act (GPRA)/ Program Assessment Rating Tool (PART) subgoal, CMS is required to "increase the number of States that have the ability to assess improvements in access and quality of health care through implementation of the Medicaid quality strategy". On January 8, 2008 CMS sent the first Quality Assessment Report (QAR) to the North Carolina Department of Health and Human Services, the State's single State Medicaid agency. During the remainder of Federal fiscal year 2008, which ended September 30, 2008, CMS issued additional QARs to the States of Arizona, Idaho, Iowa, Maryland, Minnesota, New Jersey, and Tennessee. The process of developing and issuing QARs has been shared with the National Association of State Medicaid Directors. Each Report draws on a broad array of sources and a draft is vetted through the appropriate CMS regional office. Each QAR includes information describing the State's quality initiatives; data on access and quality for the general Medicaid population and children in particular; facility- and State-specific hospital and nursing home performance measures; analyses of the State's most recent annual External Quality Review Report and State Quality Strategy; recommendations for incorporating beneficiary-centered elements into the State's Medicaid information system; descriptions of issues addressed through CMS-sponsored technical assistance provided to the State by CMS staff and contractors; quality assessments of home and community based service programs; and data on Children's Health Insurance Program (CHIP) performance. Each State is asked to provide feedback on the usefulness of information furnished in its QAR, as well as any additional technical assistance needed. CMS plans to request annual updates on the progress each State has made in utilizing this information. All States can expect to receive individual QARs in the future. While the exact order of States has not been determined, QARs will be issued in a sequence that distributes them among various geographic areas and among States with both managed care and fee-for-service delivery systems. Medicaid Has Working Relationships with Many Recently Selected Charter Value Exchanges
On February 1, 2008 Department of Health and Human Services (HHS) Secretary Mike Leavitt recognized 14 communities as the country's first Chartered Value Exchanges (CVE). Conveying this special designation represents one of a number of initiatives undertaken by HHS through its Value Driven Health Care initiative. (More information about VDHC is available via the link at the bottom of this page.) These partnerships of providers, employers, insurers, consumers, and pubic payers (including State Medicaid and other health agencies) were recognized for their strong commitment to improving quality and value in health care and for their efforts to implement innovative, collaborative approaches to transform health care at the local level. This focus on the community underscores the importance the Department attaches to advancing quality through solutions tailored to different local characteristics and circumstances. The communities selected are located in 12 different States: Louisiana, Maine, Massachusetts, Michigan, Minnesota, New York, Oregon, Pennsylvania, Tennessee, Utah, Washington, and Wisconsin. As Chartered Value Exchanges, these communities will have access to certain Medicare data on the quality of care physicians provide to patients. Combined with similar private-sector data, this information can be used to produce a comprehensive consumer guide on physician performance. In addition, CVE communities are participating in a nationwide Learning Network sponsored by HHS' Agency for Healthcare Research and Quality to facilitate peer-to-peer learning experiences through meetings and on-line resources.
State Medicaid programs and health plans have working relationships with at least 10 CVEs. This relationship can take a variety of forms – sometimes multiple forms in the same State. The State Medicaid agency may be formally represented as a purchaser stakeholder, as in Louisiana, Michigan, Minnesota, Oregon, and Utah. In Massachusetts, Michigan, Minnesota, and New York, health plans participating in State Medicaid programs are formal stakeholders in Exchanges and learning networks. Medicaid may be represented through the participation of other State government representatives in a CVE or CVE learning network, as in Louisiana, New York, and Washington. In Maine and Massachusetts, the State Medicaid program has an indirect relationship with a CVE by serving on the board of a stakeholder. (Specific information describing the involvement of Medicaid in various CVEs is available via the link at the bottom of this page.)
CMS Conducts Oral Health Quality Teleconference To obtain copies of the handouts used in this teleconference, submit your request to the Medicaid Quality Mailbox - MedicaidQuality@cms.hhs.gov.
Materials for Fall Quality Conference, November 1, 2007 Materials for this Conference can be downloaded via the link, "Fall Quality Conference 2007," below.
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