Michelle Schreiber, director of CMS’ Quality Measurement and Value-Based Incentives Group, kicked off the second day of the 2019 Centers for Medicare & Medicaid Services (CMS) Quality Conference discussing how, through technology, greater interoperability and alignment of measures can be achieved. “The future is very exciting,” Schreiber said.
Calder Lynch, senior counselor to the CMS Administrator, echoed Administrator Seema Verma’s vision from the first day of the conference and added that over half of CMS’ funding for vulnerable populations is delivered in the community and homes. “That’s the care individuals wantto receive,” Lynch said.
He went on to explain how CMS is emphasizing the improvement of voluntary reporting, so there is no undue burden on providers and states, and about the next wave of quality measurement. Lynch said the public deserves transparency in CMS’ outcomes. “The purpose of our quality measures has been to improve outcomes for people,” he said.
Federal-State Medicaid Partnership
Dr. David Kelley, chief medical officer (CMO) for the Pennsylvania Department of Human Services’ Office of Medical Assistance Programs, took the stage to share an update on the federal-state Medicaid partnership. “The culture of quality improvement must start at the top and infiltrate all aspects of a Managed Care Organization (MCO),” Kelley began.
He communicated the importance of moving beyond “traditional quality improvement” to a whole-person approach that includes addressing food insecurity and transportation issues, among other things. Kelley said that MCOs must fund programs reaching people with chronic conditions like high blood pressure through social workers and community health organizations that address diversity and focus on the whole person.
Dual Eligible Care
Tim Engelhardt, director of CMS’ Medicare-Medicaid Coordination Office, talked about improving outcomes for people dually eligible for Medicare and Medicaid, a population that includes 12 million diverse individuals like older adults and people with disabilities, many of whom have difficult socioeconomic circumstances. Despite these complexities, Engelhardt assured the room that “success IS possible” and that this means not only incremental progress, but massive improvement.
“There is so much further for us to go. Everyone in this room can put their finger on something,” Engelhardt said. “This is going to be a year in which we partner like never before.”
Taking Action on Opioids
Dr. Shari Ling, deputy CMO and acting director of the CMS Center for Clinical Standards and Quality’s Office of Clinical Engagement, explained that she took great care in naming her closing keynote Solving the Opioid Crisis: Taking Action Together. “We need to understand the root causes of what started this problem, so we don’t repeat history,” she explained.
“It is so easy to start a drug, but it takes a lifetime to understand a problem,” she said. An internist herself, Ling discussed the type of internal dialogue clinicians should have before prescribing an opiate, asking themselves what their patients need at the time — not just in terms of prescriptions — but also other therapies.
Ling went on to discuss CMS’ recent activities and successes in addressing the opioid problem. She highlighted several interventions by Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs), noting that they contributed to over 3,000 opioid adverse drug events avoided over a three-year period. “We are here to be part of the solution and it is my opinion that each of us has a piece of this puzzle to solve. So, let’s get to work,” she closed.