There is growing concern about a proposed federal change that may harm healthcare quality in New Jersey.
The Centers for Medicare & Medicaid Services (CMS) is proposing to radically change the state-based Quality Improvement Organization (QIO) program that has worked successfully in New Jersey for decades. In New Jersey, the Medicare QIO is East Brunswick-based Healthcare Quality Strategies Inc. (HQSI), which supports those of us in New Jersey working to improve quality and safety in hospitals, nursing homes and other healthcare centers.
If you've never heard of HQSI or the QIO program, it’s not surprising. HQSI has worked closely, though quietly, with the state's health care community for 30 years. It is our trusted link to Medicare.
CMS is now proposing to change this successful program, and potentially replace state-based QIOs with regional organizations. This concept is untested and there is no evidence that regionalizing the quality improvement program would work better.
HQSI is an important free resource for New Jersey's health care community. The organization brings hospitals, nursing homes and other healthcare providers together to find the best ways to reduce infection, improve the quality of patient-centered care, and reduce costs. HQSI is integral to the many hospital and community collaborations working, for instance, to reduce revolving-door hospital readmissions.
We don’t know anyone in health care quality in New Jersey who wants to see our local QIO go away.
This CMS proposal could not come at a worse time for our profession, which is already saddled with mounting regulations and requirements from the state and federal governments, the Joint Commission and health insurance companies. Regionalizing the quality improvement program would lead to more bureaucracy; we would lose the trusted advisors who help us fulfill Medicare initiatives to improve healthcare and patient safety.
We routinely call HQSI when we have questions about Medicare. Our work is highly specialized; we must meet certain requirements and deadlines in our Medicare quality reporting programs. Hospitals that don’t meet these requirements or deadlines could lose hundreds of thousands of dollars as Medicare increasingly ties compensation to quality outcomes.
This proposed change seems to be moving forward without a pilot program or public hearings — counter to the methodology behind quality improvement: Start small, test and refine.
Why blindly create another layer of far-away bureaucracy, leave it unproven, and then demand a better result?
The local QIO is our calming influence; it is reassuring to have a familiar, trusted and knowledgeable voice on the phone or during visits. HQSI’s staff has been there for us as a resource that knows the New Jersey landscape.
The team has been at hospitals and nursing homes statewide, and knows the people who run them. It is a knowledge that has taken years to cultivate and may take only a stroke of the pen to destroy.
We urge Congress, hospital CEOs, patients and others who care about healthcare quality to understand that taking away our state's QIO is just bad policy. Healthcare is local. Our state QIO is our local resource.