ESRD and the Patient Experience
The 2019 Centers for Medicare & Medicaid Services (CMS) Quality Conference kicked off on a patient-centered note with Precious McCowan and her inspiring story of a decade-long battle with end-stage renal disease (ESRD). Despite her illness and dealing with organ transplants, hospital stays and dialysis, McCowan has thrived because, as she told the audience, she took charge of her health and didn’t let kidney disease defeat her.
But McCowan was there not just to relay her story of success; she also charged those in attendance with keeping the promise of giving a voice to patients in all their quality improvement work.
“As patients we depend on you to make health care more patient-centered," McCowan said.
Welcome and Charge from CMS Quality Leadership
CMS quality leaders took the stage to thank attendees for their hard work over the past year and to request accelerated efforts in coming months. Noting that stakeholders are “getting better and better” at what they’re doing and “generating national results,” Dennis Wagner — the director of the Quality Improvement and Innovation Group (QIIG) within CMS’ Center for Clinical Standards and Quality (CCSQ) — called on attendees to do things even faster and better.
“Align with evolving CMS priorities; lean into them,” said Wagner. “Focus on patients and providers; become stewards of human-centered design; improve to lower costs, greater efficiency and better value; cultivate resilience; and partner.”
Transforming the Health Care System
As part of her keynote address, CMS Administrator Seema Verma announced major gains in quality improvement. Data released by CMS and the Agency for Healthcare Research and Quality showed a 13 percent reduction in the number of hospital-acquired conditions across the nation from 2014 to 2017. That translates to 20,500 deaths prevented and a savings of $7.7 billion to the health care system.
“That's incredible, and I know many of you in this audience have been personally involved in this important effort,” Verma said.
Verma also looked ahead to how CMS could focus even more on putting patients first by making sure quality measures offer valuable benefits. She said the agency already rolled back nearly 20 percent of measures last year because they were either topped out, duplicative or overly burdensome, and she plans on continuing that effort.
“First, measures must be patient-focused and easy to understand, so consumers can use them to pick high-quality providers.” Verma said. “[W]hen quality information is hidden or indecipherable, providers don’t have to compete on quality. If we expect to harness competition to lower costs and improve quality, patients need meaningful and actionable information.”
Fireside Chat with Innovation Center Leadership
After sharing some successes from CMS’ Meaningful Measures initiative, Kate Goodrich — Director of CCSQ and CMS Chief Medical Officer — sat down with Adam Boehler — CMS Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation (CMMI) — for a discussion about CMMI initiatives and the need to create a system that rewards outcomes instead of volume.
“Physicians did not go to medical school to churn and burn,” said Boehler. “We need to create a system where doctors can spend more time with patients.”
Taking on the Opioid Crisis
Jean Moody-Williams, Acting Consortium Administrator for CMS’ Consortium for Quality Improvement and Survey and Certification, engaged in a fireside chat with Travis Rieder, a bioethicist at the Johns Hopkins Berman Institute of Bioethics.Rieder has spent his life thinking about how medicine and the medical industry affects people, but it wasn’t until he got into a motorcycle accident that his profession became personal. Prescribed opioids for pain, Rieder became dependent on them and went through an excruciating withdrawal.
“As my brain experienced life without opioids, I thought I would die,” Rieder told Moody-Williams.
After that experience, he dedicated his research to finding a solution to the opioid crisis. Prescribers need more than just a license, Rieder said. They also need to understand how to help their patients manage and come off the medication.