[Federal Register Volume 79, Number 249 (Tuesday, December 30, 2014)]
[Notices]
[Pages 78440-78442]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-30447]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-3300-FN]
RIN 0938-ZB15
Medicare Program; Evaluation Criteria and Standards for Quality
Improvement Networks Quality Improvement Program Contracts; Base and
Task Orders
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
[[Page 78441]]
ACTION: Final notice.
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SUMMARY: This final notice announces the general criteria we will use
to evaluate the effectiveness and efficiency of Quality Innovation
Network (QIN) Quality Improvement Organizations (QIOs) that entered
into contracts with CMS under the 11th Statement of Work (SOW) in July
2014. (The activities for the QIN-QIO SOW began August 1, 2014). In
addition, this notice addresses public comments on the August 11, 2014
notice with comment period entitled, ``Evaluation Criteria and
Standards for Quality Improvement Networks Quality Improvement Program
Contracts [Base and Task Order(s)]''
DATES: Effective Dates: August 1, 2014 to July 31, 2019.
FOR FURTHER INFORMATION CONTACT: Alfreda Staton, (410) 786-4194.
SUPPLEMENTARY INFORMATION:
I. Background
Section 1153(h)(2) of the Social Security Act (the Act) requires
the Secretary of the Department of Health and Human Services (the
Secretary) to publish in the Federal Register the general criteria and
standards that will be used to evaluate the effective and efficient
performance of contract obligations by the Quality Improvement
Organizations (QIOs), and to provide the opportunity for public comment
with respect to these criteria and standards.
II. Provisions of the Notice With Comment Period
On August 11, 2014, we published a notice with comment period in
the Federal Register (79 FR 46830 through 46835) entitled, ``Evaluation
Criteria and Standards for Quality Improvement Networks Quality
Improvement Program Contracts [Base and Task Order(s)]'' to announce
the general criteria that we would use to evaluate performance of the
Quality Innovation Network (QIN)--QIOs under the QIN-QIO 11th Statement
of Work (SOW) contract beginning August 1, 2014. (Solicitation Number:
HHSM-500-2014-RFP-QIN-QIO). That notice summarized the tasks of the
QIN-QIOs and the criteria to be used for annual performance evaluations
during the 5-year term of the contract.
The evaluation of a QIN QIO's performance related to their SOW will
be based on evaluation criteria specified for the tasks and subtasks
set forth in Section C.5 of the QIN-QIO Base Contract and Attachment J-
1(b) of the QIN-QIO Task Order. The general criteria that will be used
to evaluate the QIN-QIOs under the QIN-QIO 11th SOW contract beginning
August 1, 2014, include performance of the following Tasks:
Improving Cardiac Health and Reducing Cardiac Healthcare
Disparities.
Reducing Disparities in Diabetes Care.
Improving Prevention Coordination through Meaningful Use
of Health Information Technology (HIT) and Collaborating with Regional
Extension Centers (RECs).
Reducing Healthcare-Associated Infections in Hospitals.
Reducing Healthcare-Acquired Conditions in Nursing Homes.
Improving Coordination of Care, Quality Improvement
through Value-Based Payment, Quality Reporting, and the Physician
Feedback Reporting Program.
Quality Improvement Initiatives.
The Table at Attachment J.1(b) of the SOW lists performance
measures by the following Tasks:
B.1. Improving Cardiac Health
B.2. Everyone with Diabetes Counts
B.3. (Reserved)
B.4. Meaningful Use of HIT and Collaborating With RECs
C.1. Reducing Healthcare-Acquired Infections (HAIs) in
Hospitals
C.2. Reducing Healthcare-Acquired Conditions in Nursing
Homes
C.3. Coordination of Care
D.1. Quality Improvement through Physician Value-Based
Modifiers
E.1. Technical Assistance--Quality Improvement Initiatives
(QIIs)
Evaluation Criteria. Annual (12, 24, 36, 48th month) and 54th month
Evaluation Criteria are defined in Attachment J-1(b) of the QIN-QIO
SOW.
Additional details provided in the notice are posted at: http://www.gpo.gov/fdsys/pkg/FR-2014-08-11/pdf/2014-18901.pdf.
III. Analysis of and Responses to Public Comments on the Notice With
Comment Period
A commenter affiliated with a private healthcare quality
improvement entity submitted several comments concerning the general
criteria we would use to evaluate the effectiveness and efficiency of
QIN-QIOs that entered into contracts with CMS under the 11th SOW.
A summary of the comments and our responses are as follows:
Comment: The commenter expressed appreciation for the opportunity
to submit comments on the general evaluation criteria and standards and
noted the importance of the three-part aim in the QIN-QIO SOW of better
health, better healthcare, and lower costs through improved quality for
Medicare enrollees. The commenter suggested that CMS continue its
efforts to assess the effectiveness of the QIN-QIOs using measures of:
improved patient quality and safety, improved population health,
reduction of avoidable costs, engagement of patients, families and
consumers in care and population health improvement and improved
coordination of care and integrative services.
Response: We agree with the commenter that the QIN-QIO contract and
the general evaluation criteria and standards focus on strategic
initiatives including the three part aim and the projects identified in
the QIN-QIO Task Order support our goals of the three broad aims of
better healthcare, better health, and lower healthcare costs through
improvement for all Medicare beneficiaries. Measures for better
healthcare include those for the Aim, Better Healthcare for
Communities: Beneficiary-Centered, Reliable, Accessible, and Safe Care
and includes measures for Tasks C.1 Reducing Healthcare-Associated
Infections in Hospitals,C.2, Reducing Healthcare-Acquired Conditions in
Nursing Homes, and C.3, Promote Effective Communication and
Coordination of Care. Measures for the better health include those for
the Aim, Healthy People, Healthy Communities: Improving the Health
Status of Communities and include Tasks B.1, Improving Cardiac Health
and Reducing Cardiac Healthcare Disparities, B.2, Reducing Disparities
in Diabetes Care: Everyone with Diabetes Counts, and B.4, Improving
Prevention Coordination through Meaningful Use of HIT and Collaborating
with Regional Extension Centers. Measures for lower healthcare costs
include Aim D, Better Care at Lower Cost and Task D.1, Quality
Improvement through Value-Based Payment, Quality Reporting, and the
Physician Feedback Reporting Program. These efforts will likely have a
secondary effect of aiding in the transformation of the healthcare
system.
Comment: The commenter stated that CMS should provide QIN-QIOs with
timely communication after award of the contract regarding operational
and implementation issues that may arise over the 5-year period of
performance.
Response: We agree with the need for timely, systematic
documentation of questions and answers to each QIN-QIO regarding all
aspects of the SOW, including deliverables and the evaluation measures.
We established an electronic system for submitting and documenting
responses to contract performance concerns and questions;
[[Page 78442]]
this system was made available to each of the QIN-QIOs.
IV. Comment Outside the Scope of the Notice
A second commenter submitted a comment suggesting that CMS provide
beneficiaries with an option to pay annually rather than only monthly
for the Part D benefit. This comment is outside the scope of the notice
of evaluation standards and criteria for the QIN-QIO SOW therefore, we
are not providing a response to that comment.
V. Provisions of the Final Notice
We have analyzed these comments and determined that it is
appropriate to finalize without modification the provisions set forth
in the August 11, 2014 notice with comment period entitled,
``Evaluation Criteria and Standards for Quality Improvement Networks
Quality Improvement Program Contracts [Base and Task Order(s)].'' (79
FR 46830 through 46835).
VI. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting, recordkeeping or third-party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995.
VII. Regulatory Impact Statement
In accordance with the provisions of Executive Order 12866, this
notice was not reviewed by the Office of Management and Budget.
Dated: November 19, 2014.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2014-30447 Filed 12-29-14; 8:45 am]
BILLING CODE 4120-01-P