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Qualis Health Implements New Medicare Innovation Projects, New Focus Areas in QIO Contracts

October 26, 2016

CMS Modifies Current Project Portfolio and Awards Two New Special Projects

Seattle, WA – Qualis Health has won two Special Innovation Project contracts awarded by the Centers for Medicare & Medicaid Services (CMS) to expand its work as the Quality Innovation Network – Quality Improvement Organization (QIN-QIO) for Idaho and Washington State. At the same time, CMS has modified Qualis Health’s QIN-QIO contracts to add new focus areas and align efforts with newly-awarded Hospital Improvement and Innovation Network (HIIN) contracts.

The Special Innovation Projects are:

  • Addressing Social Determinants of Health in Care Transitions. This project is designed to assess the social determinants that impact people’s transition from the hospital to home (such as access to healthy food, transportation and housing) and create robust linkages to community social service providers for high-risk patients. Qualis Health will work with a total of six hospitals in Idaho and Washington as well as social service referral organizations in the hospitals’ service areas.
  • Reducing Risks of Surgical Site Infections in Ambulatory Surgery Centers (ASCs). Qualis Health will engage a cohort of 30 ASCs in Idaho and Washington to implement proactive risk assessment of surgical site infections through technical assistance, collaborative learning and data monitoring. The project aims to reduce infections, improve infection prevention competencies and bolster infection prevention program structures.

“Our expanding portfolio of initiatives reflects our commitment to achieving a healthcare system that delivers better care, spends dollars in a smarter way and improves overall community health,” says Jonathan Sugarman, MD, MPH, Qualis Health President & CEO.

CMS has also modified Qualis Health’s 2014–2019 QIN-QIO contracts to address recent program changes. As the QIN-QIO, Qualis Health brings Medicare beneficiaries, providers, and communities together to increase patient safety, make communities healthier, and better coordinate post-hospital care. In addition, Qualis Health is providing assistance to practices to improve clinical quality and support the transition to quality-based payment programs. Program changes at Qualis Health include:

  • Directing its infection prevention and quality improvement expertise toward the implementation of antimicrobial stewardship programs in ambulatory surgery centers, dialysis clinics, physician practices and other outpatient settings of care to reduce inappropriate use of antibiotics.
  • Transitioning its role assisting hospitals in reducing inpatient healthcare-associated infections to CMS’ newly-awarded Hospital Improvement and Innovation Networks (HIINs), and collaborating with the HIINs to reduce avoidable hospital readmissions.
  • Refocusing its physician practice support to align with the recently-legislated Quality Payment Program, preparing physician practices for implementation of Medicare’s Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

For more information about Qualis Health’s complete portfolio of QIN-QIO initiatives, visit medicare.qualishealth.org.


This material was prepared by Qualis Health, the Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO) for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. ID/WA-A1-QH-2590-10-16

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