Jean Moody-Williams, RN, MPP, is the Deputy Director of the Center for Clinical Standards and Quality (CCSQ) at the Centers for Medicare & Medicaid Services (CMS). She is responsible for working with a team to lead policy activities for Quality Improvement Programs, End Stage Renal Disease (ESRD) Networks, Survey and Certification, Quality Measurement and Health Assessment, Clinical Standards, Coverage and Analysis, Quality Innovations Models and many of the agency’s Value Based Purchasing and public reporting programs for hospitals, physicians and ambulatory settings. Prior to this, she was the Group Director for the CMS Quality Improvement Group (QIG) in CMS and provided oversight for the nation’s Quality Improvement Organizations (QIOs), and the ESRD Quality Networks. She also served as the Director of Quality for CMS Medicaid Programs.
Prior to joining CMS, Moody-Williams served as an executive at a number of state and private entities working to improve care for patients and families. She is also a clinician. Moody-Williams received her Bachelors of Science in Nursing from Hampton University and a Masters of Public Policy and Management from the University of Maryland, College Park.
Q. Tell us about your role in the implementation of the CMS Quality Payment Program?
Let me start off by explaining that we are approaching this program in a very different way than we have in the past. In developing the Quality Payment Program, we have employed a user-centric design model that starts with the perspective of those most impacted by the program. Instead of sitting down, writing the program and asking for feedback, we went out into the field to hear from clinicians and patients to help inform us as we wrote the rules. My personal role in the Quality Payment Program is twofold. First, I am the chief strategic officer who helps set the direction of the program and makes sure we have a strategic plan with goals, initiatives and metrics. Also, I am a champion for engaging clinicians and consumers in the process of developing the final program, so I am involved with listening and working with stakeholders who are going to use the system. I am just one member of a very expansive and talented team.
Q. How will the Quality Payment Program help CMS—and, more broadly, HHS — meet their goals?
When we look at where we are as a nation, we are in the midst of significant change with 2,000 new Medicare beneficiaries every day. We need to look at how we will be able to provide the best care for beneficiaries in a way that engages them but that doesn’t strain the system. We also need to spend taxpayer dollars wisely. In short, we want to make sure that people get the best care, stay healthy, and that we are smart about how we are spending money. Our more concrete goal is that we are changing over to alternative payment models (APMs) that make us less reliant on traditional fee-for-service models that reward volume. The Quality Payment Program is an important driver of change to meet all of these goals.
Q. What opportunities will there be for the Quality Innovation Network-QIOs (QIN-QIOs) in supporting the Quality Payment Program?
There are tremendous opportunities for them. There could be at least 700,000 clinicians who are impacted by the Quality Payment Program. Many of them still don’t know about the coming changes, how they personally will be impacted or what they can do to be successful. Some clinicians are not convinced that change is a good thing. QIN-QIOs play an important role in reaching them at the local level. QIN-QIOs understand the environment in which clinicians are practicing and really put a face on the program within a local area. QIN-QIOs can make some sense of the new policy for clinicians, including what the new requirements are and how they impact practices. They also can help CMS understand what is not working well and where improvement is necessary. They can make connections for clinicians and show them where there are resources to help them. QIN-QIOs also can help clinicians understand the data being generated and how it can be used to transform their practices. Ultimately, the goal is not to disrupt physician practices but to give clinicians more time to spend with patients. Lastly, QIN-QIOs can help with the sharing of best practices and with coaching.
Q. In what ways will QIN-QIOs collaborate with the Transforming Clinical Practice Initiative (TCPI) on the Quality Payment Program?
QIN-QIOs are already collaborating with TCPI in several areas. There will be 140,000 clinicians involved in TCPI, and QIN-QIOs are working with many of them in analyzing their data, assessing where they are in the transformation process, and providing coaching and connections. Under the Quality Payment Program, this collaboration will increase as we want all organizations providing technical assistance to collaborate and provide one consistent message to clinicians. Each will develop tools that are helpful to the others. Through these organizations, we will have a much broader reach to everyone.
The intent of the Quality Payment Program is to ensure that beneficiaries are getting care that meets their needs in a coordinated fashion and that technologies are open and flexible, helping to innovate and improve care. Clinicians in the field should have access to the best possible information to make decisions about care and to ensure that beneficiaries are involved in decision making. Many APMs being tested and implemented have been built on the premise that clinicians will work with their office and community to integrate care in new and different ways, so it is less fragmented, and so that beneficiaries’ voices are heard. Some models are focused specifically on the beneficiary decision-making process. This will lead to a better care concept.
It is important that people tune in to a number of activities we are providing. We received a lot of helpful input before implementation, and now we are holding events, conducting outreach activities and getting feedback from our clinician champions. We have information on our website, are holding focus groups and listening sessions, and have developed informational materials. Clinicians and others can expect to learn more at the 2016 CMS Quality Conference in December as well.
Q. Anything else you would like QIO News readers to know?
We are looking at the flexibilities provided by the Quality Payment Program to ensure that technology supports clinicians and empowers patients. We want to level the playing field and include new partners in technology development. CMS doesn’t have all of the answers. We want to encourage flexibility for health IT to meet the needs of physician practices and address real-world applications.