QIN-QIOs Awarded Contracts to Improve Identification of Behavioral Health Conditions

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In July 2015, the Centers for Medicare & Medicaid Services (CMS) awarded six Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) from the CMS QIO Program a four-year contract to improve the identification of behavioral health conditions among Medicare beneficiaries in primary care and care transitions settings.

Under the contract, QIN-QIOs are working directly with health care providers in collaboration with inpatient psychiatric facilities to implement evidence-based practices and systems changes that increase the identification of seniors with depression or alcohol use disorder in primary care settings. QIN-QIOs will also work to reduce 30-day readmission rates and increase outpatient follow-ups for psychiatric discharges.

Depression and alcohol use disorder are common behavioral health conditions in the Medicare population.  Nevertheless, they are frequently under-identified in primary care settings.  Additionally, challenges in effective care transitions for these and other behavioral health conditions contribute to high readmission rates and problems in treatment adherence.

By 2019, CMS aims for 10,000 primary practices to screen a majority of its Medicare beneficiaries for depression and alcohol abuse with a validated screening instrument, reaching a total of 1.5 million beneficiaries.  Additionally, CMS plans to reduce psychiatric readmission rates in inpatient settings and increase patient follow-up rates with behavioral health practitioners following discharge.

Following is a table showing the specific states in which QIN-QIOs will be conducting quality improvement activities under the contract:

QIN

States/Territories Covered by Contract

TMF

Arkansas, Missouri, Oklahoma, Puerto Rico, Texas

Lake Superior

Michigan, Minnesota, Wisconsin

HealthInsight

Nevada, New Mexico, Oregon, Utah

Health Services Advisory Group

Arizona, California, Florida, Ohio, U.S. Virgin Islands

atom Alliance

Alabama, Indiana, Kentucky, Mississippi, Tennessee

Alliant Quality

Georgia, North Carolina