Great Plains Quality Innovation Network

Please visit the Great Plains QIN website by clicking the logo above to learn more about our Quality Improvement Initiatives, and to access provider-specific resources and tools.

For many years, the Medicare Quality Improvement Organization (QIO) Program has provided beneficiary protection, case review services and quality improvement technical assistance to providers through state-based contracts with the Centers for Medicare & Medicaid Services (CMS).

CMS made some significant changes to the QIO program. Under the new structure, case review and quality improvement functions are being performed by two different types of contractors. This change went into effect on August 1, 2014. Healthcare providers and Medicare consumers within Kansas must now contact KEPRO at 855-408-8557 for all Medicare discharge/termination of service appeal requests and quality of care concerns.

The Kansas Foundation for Medical Care, CIMRO of Nebraska, Quality Health Associates of North Dakota and the South Dakota Foundation for Medical Care recently aligned to form a new not-for-profit organization—the Great Plains Quality Innovation Network (Great Plains QIN)—which has been awarded the CMS contract to serve as the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Kansas, Nebraska, North Dakota and South Dakota. Our focus will continue to be on quality improvement and offering technical assistance.

Each of the four Great Plains QIN state partners share a commitment to improving quality of care and working to ensure that all consumers receive the right care, at the right time, every time. KFMC will continue to focus on improving care in conjunction with the other state partners, while pooling resources and common elements into an organization that can best serve the needs of healthcare providers and Medicare consumers across the Great Plains region. We will collaborate with providers and the community on multiple, data-driven quality initiatives to improve patient safety, reduce harm and improve clinical care locally and across the network.

The Great Plains QIN will engage providers, consumers, caregivers and stakeholders in Learning and Action Networks (LANs) focused on various quality improvement initiatives. These networks will serve as information hubs for learning, collaborating and elevating the voice of the consumer during the current five-year QIN-QIO contract. We will offer skills and assistance in the following focused areas:

Improving Cardiac Health and Reducing Cardiac Health Disparities
Our planned improvement efforts align with the national Million Hearts® initiative that seeks to prevent one million heart attacks and strokes by 2017. Partnering with providers in the home health and physician office settings, we will offer resources and technical assistance in using data to drive quality efforts and improve clinical quality measures, including aspirin use, blood pressure control, cholesterol management and smoking cessation and intervention. Innovative best practices to improve cardiac health and empower Medicare consumers to make heart-healthy choices will be identified and shared.

Reducing Disparities in Diabetes Care: Everyone with Diabetes Counts
Working with healthcare providers, practitioners, Certified Diabetes Educators (CDE™) and community health workers, the Great Plains QIN seeks to improve the quality of life for persons with diabetes by preventing and lessening the severity of complications resulting from the disease. In addition to teaching people with diabetes self-management skills and the importance of seeking regular screenings by healthcare providers, the Great Plains QIN will work directly with physician offices and providers to improve adherence to clinical guidelines for diabetes screening and management.

Improving Prevention Coordination through Meaningful Use of Health Information Technology
Great Plains QIN will collaborate with the Regional Extension Centers and other stakeholders to build on prior successes in improving the electronic health record adoption rates and workflow and practice transformations. The goal is to further improve adoption and transformation rates, to increase the number of providers screening for and delivering preventative services, improve access to and coordination of care, and reduce or eliminate disparities in access and utilization of recommended healthcare services for Medicare consumers. For more information regarding the cardiac, diabetes or prevention initiatives, contact Kaitlin Nolte.

Nursing Home Quality Improvement
Partnering with nursing home and Skilled Nursing Facility partners and stakeholders, we will identify strategies to enhance consumer engagement, strengthen processes and standards, create strategic partnerships and advance quality. The goal is to increase resident outcomes and improve overall satisfaction. This work will be carried out using the National Nursing Home Quality Care Collaborative as a framework. Specifically, we will work to improve the Nursing Home Quality Composite Measure Scores, improve the mobility of residents, decrease the unnecessary or inappropriate use of antipsychotic medications, decrease healthcare-associated infections, decrease other healthcare-acquired conditions and decrease avoidable hospitalizations. Brenda Groves is leading the nursing home project; contact Brenda Groves for more information.

Quality Reporting and Incentive Programs
Our staff will partner with eligible physicians, physician groups and other eligible healthcare providers to prepare them to meet the requirements of the CMS Value-Based Modifier program in which a publicly reportable performance score, as displayed on CMS’ Physician Compare website, determines payments by incorporating quality measures and cost of care data. We will assist these providers to report via the Physician Quality Reporting System (PQRS) and the value-based payment modifier/Physician Feedback program. Our staff will partner with hospitals, Ambulatory Surgery Centers and Inpatient Psychiatric Facilities to improve overall performance levels in CMS’ Value-Based Purchasing programs.

To learn more, contact one of our project managers below.

Communities of Care
Improving care coordination leads to better consumer outcomes and overall satisfaction, reduces avoidable hospital admissions and readmissions, and improves medication safety. Great Plains QIN will partner with communities throughout the region to unite stakeholders, consumers and healthcare providers to reduce avoidable hospital admissions, readmissions and medication harm, and increase community tenure. The national goal is a 20 percent reduction in avoidable hospital readmissions and admissions and a 10 percent increase in community tenure by August 2019. To learn more, contact Vanessa Lamoreaux.

Consumer and Family Engagement
Collectively, our project teams will communicate with providers and practitioners regarding the needs of healthcare consumers and their family members and/or representatives. Our staff will work to equip consumers and their families with the tools and strategies necessary to enable them to successfully navigate the healthcare system. Across Great Plains QIN, healthcare consumers, family members and advocacy organizations will actively and fully participate in project design and implementation to ensure that the needs of the consumers we serve are always taken into account. Consumers' and family stories will be shared during working sessions, educational events, via newsletters, social media and other communication channels to create momentum for quality improvement activities. Special emphasis will be placed on capturing and sharing a diverse set of stories highlighting the impact of disparity issues as they relate to healthcare experience. To ensure materials are of value and user-friendly, healthcare consumers will be asked to review and offer input on the content and distribution methods of educational materials developed as part of the various quality improvement projects. Utilizing evidence-based tools, Great Plains QIN will provide healthcare professionals the necessary tools and support for improving consumer communication and involving an individual in his or her own care. For more information on how you can become more engaged in your health, contact Megan Skaggs.

Next Steps
We are very excited about this opportunity and will share more details about our work and how you can get involved. We look forward to partnering with you and expanding our reach as the Great Plains QIN. We hope you join our efforts as we strive to achieve better care, better health for people and communities, and more affordable care through quality improvement.