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CMS Quality Strategy for 2013 & Beyond Introduced

The Centers for Medicare & Medicaid Services (CMS) released its “Quality Strategy” on November 18th, 2013, which was created as part of the requirements of the Affordable Care Act. Development of a plan to achieve the goals it has set out is now underway. The agency will try to complete its objectives through drivers such as increased measurement and public reporting of providers’ quality performance as well as creating survey and certification processes that evaluate capacity for quality assurance and quality improvement.  CMS has set the following six goals as part of its strategy to improve quality in US healthcare:

  1. Make care safer by reducing harm caused in the delivery of care – By promoting a culture of safety and a reduction in inappropriate/unnecessary care, CMS seeks to reduce healthcare-related harms. Areas where they are seeking improvement include prevention of hospital-acquired conditions, reduction in medication error rates, and a decrease in the number of falls.
  2. Strengthen person and family engagement as partners in their care – Empowering patients and their families to partner with their caregivers helps them be informed, as well as reduce costs and disparities in care provided. CMS will try to improve the quality measurement for patient/caregiver engagement and promote more data transparency. This will help preferences to be honored since they will be part of the decision-making process, and will help achieve patient-centered goals that focus on prevention.
  3. Promote effective communication and coordination of care – CMS notes that poor coordination of healthcare results in med errors, unnecessary treatments, avoidable hospital admissions and readmissions, as well as other harm to patients. One of the objectives of this goal is to have survey results that demonstrate a measurable reduction in deficiencies given related to discharge planning and care transitions.
  4. Promote effective prevention and treatment of chronic disease – Over 133 million Americans have a chronic disease, and CMS is putting programs in place to reduce leading causes of mortality, including cardiovascular disease and obesity.
  5. Work with communities to promote best practices of healthy living – To promote best practices in all communities, CMS is working with partners to provide better resources that support good health, including high-quality community based programs. Initiatives such as the Program for All-Inclusive Care for the Elderly (PACE) will help reduce healthcare costs because they will lead to better care coordination
  6. Make care affordable – CMS has identified several ways to lower healthcare costs and will work on initiatives to achieve them, including reducing med errors and improving care coordination, adding more publicly available reporting data, and developing and enhancing quality standards and clinical guidelines. Additionally, performing more auditing and fraud investigations bas been a continued focus of CMS and these investigations will continue to expand in coming years.

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