Renee Kinder

Spring is in the air!

We all welcome the annual change in seasons, which also comes with a rush to review, digest and comment on multiple proposed rules.

April 2022, however, also brings us a renewed approach and initiatives from the Centers for Medicare & Medicaid Services regarding its National Quality Strategy.

What is the CMS National Quality Strategy?

Specifically stated, the Centers for Medicare & Medicaid Services will set and raise the bar for a resilient, high-value healthcare system that promotes quality outcomes, safety, equity and accessibility for all individuals, especially for people in historically underserved and under-resourced communities.

Furthermore, clarifications are provided on key domains we see in the industry including person-centered care, and care across the continuum.

Noted in its stated objectives the CMS National Quality Strategy takes a person-centered approach to quality and safety and seeks to improve the overall care journey as individuals move across the continuum of care, from home- or community-based settings to hospitals and post-acute care.

This all sounds great, right?

So, what do interdisciplinary teams need to know about the timeline and recent changes?

•  2017 – CMS developed a new quality measures framework focused on increasing measure alignment across CMS programs and other public and private initiatives.

•  2020 – Included the voices of patients in performance measures by increasing the number and use of Patient Reported Outcome Measures (PROMs) and Patient Reported Outcome Performance Measures (PRO-PMs) on the CY 2020 list of measures under consideration.

•  September 2021 – CMS continued to modernize the Care Compare sites to increase transparency and ensure that all individuals that CMS serves, as well as their families and caregivers, have the information to make informed care decisions.

•  April 2021 – CMS targeted the efforts of the Quality Improvement Organizations (QIOs) during the COVID-19 Public Health Emergency to help nursing homes strengthen their infection control systems, increase resident and staff COVID-19 vaccination rates, and ensure quality and safety.

•  October 2021 – CMS adopted a new quality measure, the Maternal Morbidity Structural measure, for the Hospital Inpatient Quality Reporting (IQR) Program that asks hospitals to attest to whether they participate in a statewide and/or national maternal safety quality collaborative and whether they have implemented the recommended patient safety practices or bundles to improve maternal outcomes. Through this measure and others, CMS intends to propose the establishment of a maternity care quality hospital designation to be publicly reported on

•  FY 2022 – Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule, CMS solicited feedback from stakeholders on opportunities to advance equity and close gaps in care through quality measurement.

•  FY 2022 – Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule, CMS sought feedback to support and modernize its quality measurement enterprise in the future including clarifying a potential definition of digital quality measures; leveraging technological opportunities to facilitate digital quality measurement; and using the Fast Healthcare Interoperability Resources (FHIR®) standard for electronic clinical quality measures (eCQMs) that are currently in the various quality programs.

•  January 2022 – CMS released information related to nursing home staffing as a vital component of a nursing home’s ability to provide quality care, specifically for residents and their families as they consider a nursing home for themselves or a loved one.

•  April 2022 – Updates posted to the CMS website for the National Quality Strategy

2022 CMS National Quality Strategy goals:

•  Embed Quality into the Care Journey: Incorporate quality as a foundational component to delivering value as a part of the overall care journey. Quality includes ensuring optimal care and best outcomes for individuals of all ages and backgrounds, as well as across service delivery systems and settings. Quality also extends across payer types.

•  Advance Health Equity: Address the disparities, structural racism, and injustices that underlie our health system, both within and across settings, to ensure equitable access and care for all.

•  Foster Engagement: Increase engagement between individuals and their care teams to improve quality, establish trusting relationships, and bring the voices of people and caregivers to the forefront.

•  Promote Safety: Prevent harm or death from healthcare errors.

•  Strengthen Resilience: Ensure resilience in the healthcare system to prepare for, and adapt to, future challenges and emergencies.

•  Embrace the Digital Age: Ensure timely, secure, seamless communication and care coordination between providers, plans, payers, community organizations and patients through interoperable, shared and standardized digital data across the care continuum.

•  Incentivize Innovation & Technology: Accelerate innovation in care delivery and incorporate technology enhancements (e.g. telehealth, machine learning, advanced analytics, new care advances) to transform the quality of care and advance value.

•  Increase Alignment: Develop a coordinated approach to align performance metrics, programs, policy, and payment across CMS, federal partners, and external stakeholders to improve value. Strive to create a simplified national picture of quality measurement that is comprehensible to individuals, their families, providers and payers.

Ready to learn more?

You can visit the CMS National Quality Strategy website. 

To provide feedback, email [email protected]

Renee Kinder, MS, CCC-SLP, RAC-CT, is Executive Vice President of Clinical Services for Broad River Rehab and a 2019 APEX Award of Excellence winner in the Writing-Regular Departments & Columns category. Additionally, she serves as Gerontology Professional Development Manager for the American Speech Language Hearing Association’s (ASHA) gerontology special interest group, is a member of the University of Kentucky College of Medicine community faculty and is an advisor to the American Medical Association’s Current Procedural Terminology CPT® Editorial Panel. She can be reached at [email protected].

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.