Hospitals in rural and/or medically underserved areas now have access to federally funded assistance through a new Hospital Quality Improvement Contractors (HQIC) program. As a potential HQIC, TMF Health Quality Institute aims to improve health care quality by partnering with eligible facilities identified by the Centers for Medicare & Medicaid Services (CMS). Recruitment is currently underway.
TMF has a 45-year established history of supporting health care providers and serving as a trusted local partner in improving quality of care. As a HQIC awardee, TMF can further assist you on the ground by providing technical assistance and expertise to improve hospital quality of care and overall community health.
Strengthening the quality of health care for patients with measurable results is the core of TMF’s mission. Since 1984, TMF has been under contract with CMS as a Quality Improvement Organization (QIO), improving care provided to Medicare beneficiaries through cooperative efforts with the health care community. Our longtime experience in this field enables us to understand the ongoing and increasing challenges faced by hospitals.
For the new HQIC program, TMF is recruiting 300 hospitals to commit to collaborate with us for technical assistance, important services and intervention support.
CMS has mandated HQICs to engage with facilities meeting the following criteria:
- Rural hospitals
- Critical access hospitals
- Serving vulnerable populations
- Classified as low-performers
- Have a below-average star rating (two or lower) on Hospital Compare in every year that the hospital has been evaluated within the last four years (FY 2017-2020)
- Caring for populations with no access to an alternative hospital setting that provides higher-quality services and populations who may be vulnerable to poorer outcomes
HQICs will also provide support to specific hospitals for intervention based on CMS survey assessment findings and/or the Centers for Disease Control and Prevention’s guidance or other criteria as necessary.
HQICs will focus on vulnerable populations to ensure goals are achieved and to ensure public safety.
HQICs will identify and address vulnerable populations including:
- Medically underserved areas
- Chronically ill and disabled
- Low-income and/or homeless individuals
HQIC Areas of Focus and Goals
As a HQIC awardee, TMF Health Quality Institute can support your facility in working toward the following goals:
- Improve access to behavior care and improve behavioral health outcomes
- Decrease opioid-related adverse events by 7%, including deaths with a focus on the Medicare population
- Using current best practices and patient-centered approaches, decrease opioid by 12%
- Improve access to behavioral health services
- Impact care of vulnerable populations in areas challenged by appropriate access to medical care for opioid misuse and overdose issues
- Focus on acute care, short-stay hospitals in rural areas
- Focus on critical access hospitals and medically underserved geographic areas serving vulnerable populations as defined by CMS
- Deploy evidence-based practices and multi-disciplinary interventions
- Scale best practices while fostering innovation and promising approaches to diagnose, prevent and treat opioid-related adverse events, misuse, and abuse.
This work will allow CMS great flexibility and local leadership for a variety of quality improvement services and interventions that can be achieved through innovation around the management of pain, broad research on current gaps in care and data.
- Reduce all-cause harm in hospitals, including adverse drug events (ADEs), by 9% or more by 2024
- Reduce readmissions by 5% for Medicare beneficiaries by 2024
- Reduce ADEs in hospitals by 13%
- Reduce Clostridioides difficile (C. diff) in hospitals
According to CMS, despite advancements in infection control and injury prevention, hospital-acquired conditions continue to have a high financial burden on the health care system and contribute significantly to inpatient morbidity and mortality in the United States.
Additionally, rural health care systems often try to serve communities with an overworked and shrinking health care workforce. Due to the financial pressures and changing demographics, rural hospitals across the country have been closing, thus eliminating essential health care services. The lack of access to high-quality health care for people in these areas make them vulnerable to poorer outcomes, higher health care costs and increased morbidity and mortality.
- Reduce hospital readmissions by 5%
CMS notes that Medicare beneficiaries in rural areas are less likely to seek follow-up care after hospital visits, which may increase their risk for visits to emergency departments (EDs) and for hospital readmissions. They are also less likely to have follow-up health care visits within 30 days of leaving the hospital. Compared to patients in urban areas, rural-area patients are at higher risk of ED visits as well as unplanned readmissions. Many of these factors are influenced by additional challenges such as poor transportation, poor access to care and multiple comorbidities.