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CMS Delays Funding Renewal for Kansas' Quality Improvement Organization Contractor

August 12, 2019

The Kansas Foundation for Medical Care (KFMC), a Topeka based quality improvement organization, expresses deep concern about the immediate and long-term impacts of a recently announced lapse of up to four months in the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) program will have on the Medicare quality infrastructure.

KFMC is a not-for-profit organization focused on improving healthcare quality and has served as the state-based QIO designated by the Centers for Medicare and Medicaid Services (CMS) since the program’s national inception, most recently working as part of the Great Plains Quality Innovation Network (Great Plains QIN). CMS announced that the QIN-QIO program may lapse for as long as four months in a June 26 notice sent to quality contractors. Since July 17, the QIN-QIO program has ceased to provide quality improvement technical support to Medicare participating hospitals, doctors, and post-acute facilities. CMS also ordered all referred casework from Medicare beneficiary quality complaints to cease as of July 17.

“For over 40 years, KFMC has worked closely with Kansas Medicare providers of all types to move the Kansas healthcare delivery system toward one that empowers healthcare consumers and knowledgeable, fulfilled healthcare professionals. We have worked diligently with our partners to promote optimum healthcare delivery in a safe environment across Kansas,” said Sarah Good, CEO of KFMC. “The assistance we provide as part of the QIO program is at no cost to providers and in our rural, resource-challenged delivery environment, this assistance is critical to helping providers navigate the increasingly complex regulatory and reimbursement environment ensuring their success and financial sustainability.”

The QIO program is a mandatory federal program with specific requirements to deliver technical assistance to Medicare providers for the purposes of quality improvement. QIOs are required to be independent and impartial so they can work as a trusted partner across multiple settings of care. In the last statement of work, organizations like KFMC and Great Plains QIN have made incredible progress nationally to improve the health status of communities through direct beneficiary engagement, reduced hospital readmissions, improved nursing home care, helped physicians navigate the new Quality Payment Program, and saved the Medicare Trust Funds billions of dollars.

KFMC is concerned about the immediate and long-term impacts this lapse is having on the Medicare quality infrastructure. In addition to the mandatory functions of the program terminating, there have been national layoffs and furloughs of QIN-QIO staff, including physicians, nurses, and health quality experts with decades of experience. As the lapse continues, those staff will be faced with hardships and the need to find alternative employment, representing a devastating migration of expertise out of the QIO sector.

Through this time of transition, KFMC remains committed to their mission and will continue to work hand-in-hand with local providers, consumers, and stakeholders across the continuum of care when Kansas’ Medicare beneficiaries receive medical care; regardless of the setting, it’s the best and safest care possible. Technical assistance and support continue to be available in a limited capacity. Please visit our website, kfmc.org, or contact any of our quality improvement consultants at 1-800-432-0770 for assistance.