These QIN-QIOs Tackled Malnutrition to Improve Beneficiary Wellness

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Health disparities are the differences in health outcomes that are closely linked to social, economic and environmental disadvantages. Race and ethnicity, disability status, rural residency, socioeconomic status and other characteristics can create disparities, including malnutrition that have far-reaching consequences.

Over the past five years, the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) focused on reducing the disparities that may affect beneficiaries. With health equity, CMS beneficiaries can better access quality health care, leading to improved outcomes including in nutrition and wellness. 

QIN-QIOs partnered with a variety of health organizations for activities to raise awareness about disparities,” Brianna Glass, senior program manager at Telligen, the QIN National Coordinating Center (NCC) and QIN-QIO for Colorado, Illinois and Iowa, said in a recent webinar. 

Held June 12, the QIO Program’s most recent National Disparities Learning and Action Network (LAN) webinar was titled Addressing Disparities through the QIO Program: Looking Forward, Looking Back.” The event highlighted how QIN-QIOs addressed disparities during the QIO Program’s 11thScope of Work, which spanned 2014 to 2019

The LAN event highlighted the work of QIN-QIOs like Atlantic Quality Innovation Network (AQIN) serving New York, South Carolina and Washington, D.C.

Putting an End to Malnutrition

Sara Butterfield, senior director at AQIN – NY, described how they saw an opportunity to reduce malnutrition in their patients and researched the impact of nutritional status on readmission rates. They found that malnourished patients are hospitalized an average of two days longer than those screened and treated early, and 45% of patients who fall in the hospital are malnourished. A significant number of patients ended up being malnourished because of food insecurity as well, Butterfield said.

We looked at the impacts of malnutrition, and we wanted to know how to identify it in the community and be proactive about it,” said Butterfield.

The QIN-QIO realized that if malnutrition was screened for when patients entered a system, it was not communicated to the other stakeholders down the line. To combat this, the AQIN partnered with several health care organizations to form a subcommittee and created a nutritional toolkit, Butterfield said. By providing the toolkit, it created a more natural way for hospitals and other health care organizations to identify malnutrition, make sure it was diagnosed correctly, and provide a process for follow-up communication and assessment.

The importance of having community-based coalitions at the table to identify food insecurity and malnutrition was highlighted throughout our work,” she said.