ent formation ograms - AHQA...k Orders. 38 12 th rder X rdee X ons X ble er X sed. 39 t X cts X...
Transcript of ent formation ograms - AHQA...k Orders. 38 12 th rder X rdee X ons X ble er X sed. 39 t X cts X...
CMS Q
uality Programs
Request for Information
Industry EventO
CTOBER 5, 2017
DENN
IS WA
GN
ER, MPA
DIREC
TOR, Q
UALITY IM
PROVEM
ENT & IN
NO
VATIO
N G
ROUP
CEN
TERS FOR M
EDICA
RE & MEDIC
AID SERVIC
ES U.S. DEPA
RTMEN
T OF HEA
LTH & HUMA
N SERVIC
ES
2A
genda
Welcom
e :15Fram
ing Our W
ork :15Q
I Programs :15
Contracting O
verview :15
Break :20Q
uestion Response :25N
ext Steps & Close :15
3Introd
uction of Today’s Speakers
Jeneen IwugoDeputy Director,
QIIG
Dr. Paul McGannChief Medical
Officer for Quality
Improvement, QIIG
Kim TatumContracting Officer, Division of Quality
Contracts,OAGM
Phyllis LewisDirector, Division of Quality Contracts,
OAGM
Traci ArchibaldDivision Director of ESRD, Population and Community
Health, QIIG
Greg GesterlingContractor
Compliance Officer, Policy, Quality, Data &
Systems, OAGM
4Poll –
Who’s In the A
udience
XTell us w
hat sta
keholder group
you represent?
XQ
IN-Q
IO
XH
IIN
XESRD
Netw
orks
XTC
PI
XO
ther
XTell us how
ma
ny peop
le are in the room
pa
rticipa
ting with you.
X1 (you)
X2
X3
X4
X5 or m
ore
5W
e get more of w
hat we focus on…
XFocus on p
roblem
s –m
ore problems
XFocus on success –
more success
XFocus on w
hat works -m
ore of wha
t works
XFocus on good
stories –m
ore good stories
XFocus on good
results –m
ore good results
We can choose w
hat we focus on!
6M
indset…
Net Forw
ard Energy
7Q
uestions To Run On –
CM
S Plans to
Answ
er These Questions in this Session
XW
hy is CM
S conducting a
n RFI and Ind
ustry Day?
XW
hat are em
erging HH
S/CM
S/CC
SQ/Q
IIG goa
ls?X
Wha
t is a NQ
IIC?
XW
hat is C
MS looking for from
our NQ
IIC offerors?
XW
hat are the benefits of this a
pproach to contractors
and
to the government?
XW
hy is the structure of NQ
IIC im
portant to C
MS?
8Q
uestions for Industry D
ay Participants
XC
ontract type/vehiclea
. Is your organization interested
in pursuing work
under the new
NQ
IIC ID
IQ contract structure?
b. Which w
ork type or work types you are interested
in perform
ing?X
What w
ould incentivize your organization to submit a
proposal?X
What are the three highest priorities/desired outcom
es for future quality im
provement efforts that your
organization is ideally configured to generate?a. A
t what scale are you prepared
to work?
9Q
uestions for Industry D
ay Participants
XW
hat do you recomm
end and what innovative approaches have you
employed to address w
orkforce burden reduction?X
What innovative considerations/recom
mendations do you have
regarding structure, scale and scope of individual Quality
Improvem
ent Task Orders?
a. Wha
t innovative ideas d
o you have or has your organization
begun to test that could generate significant results?
XW
hat measures and m
easures systems do you m
ost recomm
end for us to track the im
provement from
our quality work?
XFor Q
IN-Q
IO Task O
rders that require geographic coverage: What
factors are important to you w
hen proposing to cover a geographic area of the country? W
hat suggestions do you have in structuring task orders to allow
for greatest flexibility and cost efficiencies?
10C
MS A
dm
inistrator Seema V
erma
“We w
ant
accounta
bility –
for outcom
es, not process.”
11O
ur End G
oal
Further Cha
nges in CM
S App
roaches to QI W
orkUsher in a N
ew Era
of FlexibilityX
Put Patients FirstX
Greater collabora
tion, transparency and a
ccountability X
Be far more flexible on the “how
” and tighter on the
“what” outcom
esX
Fewer, m
ore important m
easuresX
Focus on outcomes/results aligned
with C
MS &
HHS
overarching goals
XLess reporting, few
er deliverables, and
more im
provement
work
Framing O
ur Work
DR. PA
UL MC
GA
NN
, CHIEF M
EDIC
AL O
FFICER FO
R QUA
LITY IM
PROV
EMEN
T
JENEEN
IWUG
O, D
EPUTY DIREC
TOR, Q
IIG
TRAC
I ARC
HIBA
LD, D
IVISIO
N D
IRECTO
R FOR ESRD
, POPULA
TION
A
ND
CO
MM
UNITY H
EALTH
, QIIG
13Principles on w
hich our Programs
Operate
XA
ims create system
s, systems genera
te results
XW
e try to do m
ore of what w
orksX
We try to m
ake best-in-class
performa
nce, comm
on performa
nceX
Tight about the “w
hat”—O
utcome;
flexible on the “how”
XA
lwa
ys focus on Results
14H
ow is C
MS p
ositioned to a
chieve the H
HS/C
MS/C
CSQ
/QIIG
goa
ls?
15W
hat is a
NQ
IIC?
XServe as…X
Qua
lity improvem
ent expertsX
Cha
nge agents for healthcare
transforma
tion by achieving bold
aim
sX
Use data
-driven m
ethodologies
suitable for spread
16W
hat is C
MS looking
for from our
offerors?
XServicing m
ultiple area
s
XM
eeting the unique needs of the
population a
nd hea
lthcare provid
ers
17C
urrent QIN
-QIO
Regional M
ap from
11thSO
W
18C
urrent ESRD N
etworks
19C
urrent Landscape is C
omprised
of “Sets” of Sepa
rate Contracts
XC
MS anticipa
tes incorporating potential future quality im
provement w
ork into an Umbrella ID
IQ C
ontractX
CM
S anticipates that task orders und
er the new
Umbrella C
ontract w
ill be approached
in manner
similar to current Q
I work; exam
ples:X
QIO
Task Ord
ers: Industry-d
etermined
service areas, m
ultiple QIN
s, national support contracts to support the w
ork of QIN
s
XESRD
Netw
ork Task Ord
ers: Pre-determ
ined geographic
regions, multiple netw
orks, national support contracts to support the w
ork of ESRD N
etworks
20W
hat a
re the benefits of the
prop
osed ID
IQ Um
brella
ap
proa
ch to q
uality im
provem
ent work?
XPositions governm
ent and contractors to respond
quickly to cha
nging needs and
situationsX
Continues “inclusive” app
roach to tapping sp
ecial a
uthorities, expertise, and relationships of Q
IOs,
hospital a
ssociations, national provider associations a
nd others
XO
pens up multiple, abund
ant opportunities for organizations w
ith specialized
QI expertise to ha
ve ra
pid access to evolving Fed
eral QI need
sX
Flexibility to use different types of m
ore tailored
contracting options (firm
fixed price, cost + fixed
fee, others) w
ithin a single QI um
brella contract
21W
hy is the structure of NQ
IIC
imp
ortant to C
MS?
XProvid
es flexibilityX
Contract w
ill involve a broa
d range of
healthca
re quality im
provement
services involving data-d
riven initiatives to optim
ize health outcom
es for persons a
nd fa
milies w
hile supporting clinicians, provid
ers, patients, fam
ilies a
nd com
munities in im
proving health
and
healthca
re of the population they
serve.
22O
ur Approach to C
linical Quality
Improvem
ent Work
XUse Results-D
riven ap
proach to support successful and
m
eaningful Q
I initiatives
XFocus contra
cting on outcomes and
results, while
providing m
aximum
flexibility to offerors in “how” the
results are achievedX
Directly team
and w
ork with beneficiaries through
active Person/Patient a
nd Fa
mily Engagem
ent (PFE)X
Use data
to drive innova
tion and
changeX
Share data transpa
rently across qua
lity improvem
ent organizations a
nd provid
er organiza
tions
Quality
Improvem
ent Progra
ms
TRAC
I ARC
HIBA
LD, D
IVISIO
N D
IRECTO
R, ESRD, PO
PULATIO
N A
ND
C
OM
MUN
ITY HEALTH
, QIIG
24
Jul/Aug 2017Sept 2017-Feb 2018
Mar–Dec
2018
QIN
-QIO
ESRD
Hospital
Improvem
ent
•N
ew priorities
•Em
erging needs•
TBD
OTH
ER
Quality Im
provement
New
Under N
QIIC
is a Single Quality
Improvem
ent Umbrella C
ontract
Plus a More Integrated A
pproach to Cross-cutting Support C
ontracts: Evaluation, Patient and Fam
ily Engagement, C
ontent Development, m
ore
NQ
IIC
25Substantially D
ifferent Approa
ch via Q
uality Improvem
ent Umbrella
Contract
XA
ligned w
ith new C
MS &
HHS Goals &
PrioritiesX
Maxim
izing patient experience, engagement, choice
and
outcomes –
Put Patients First in genera
ting results that m
atter
XSupp
ort local/state leadership and
engagement
XFocus on outcom
es & results w
hile substantially increa
sing flexibility on “how
” outcomes are achieved
XEsta
blish ability to ad
d new and
evolving work efficiently
26Q
uality Innovation Netw
orks –Q
uality Improvem
ent Organizations
XStatutory requirem
entsX
Must ha
ve a governing bod
y that includes at lea
st one individual w
ho is a representa
tive of health care provid
ers and at least one individ
ual who is
representative of consum
ers.X
Must not be a health care facility, health care facility affiliate and
must not
subcontract with a
health ca
re facility to perform
any case review
activities except the qua
lity of care.
XM
ust not be a payor organiza
tion except as provided
in §475.105(a)(3).X
Must d
emonstra
te the ability to perform the functions of a Q
IO including
XFocused on results
XProvid
e quality improvem
ent support to wid
e variety of healthca
re organization typ
es: nursing hom
es, clinical practices, hospice, home health, hospitals
XSupp
ort providers in com
plying with qua
lity reporting requirements
XIntegra
tive work to connect the d
ots am
ong healthcare provid
er organizations on w
ork like com
munity coalitions to im
prove patient ca
re transitions and more
27End
Stage Renal Disease (ESRD
) N
etworks
XSta
tutory Mand
ate: Social Security A
ct §1881(c)created
the ESRD
Netw
orks to utilize quality improvem
ent to ensure quality
of care and
access to care for ESRD
patients
XESRD
Netw
orks focus on patient-centered care, rapid
cycle im
provement a
nd outcom
es
XESRD
Netw
orks transparently share data across netw
orks
XESRD
Netw
orks conduct perform
ance-based quality
improvem
ent activities
XIncreasingly focus on sm
aller set of key outcomes, and
greater reach to help all 6,000 d
ialysis facilities
28Hospital Im
provement &
Innovation Netw
ork
XPursue and
achieve quantitative AIM
s in results-based task
orders
XFocus on key priorities of the A
dm
inistration
XSustain national scope &
action of effective improvem
ent w
ork (e.g., with 80%
or more of all US hospitals)
XLead
in continuous improvem
ent and culture change
XUtilize sm
all set of key outcom
e measures and
transparent sharing of d
ata for rapid evolution and
improvem
ent
XBe prepared
with a flexible quality im
provement ID
IQ
contracting mechanism
that can respond to em
erging needs
29O
ur End G
oal
Further Cha
nges in CM
S Approaches to Q
I Work
Usher in a N
ew Era of Flexibility
XPut Pa
tients First
XG
reater collaboration, transparency and accountability
XBe far m
ore flexible on the “how” and
tighter on the “what”
outcomes
XFew
er, more im
portant measures
XFocus on outcom
es/results aligned w
ith CM
S & HHS overarching
goals
XLess reporting, few
er deliverables, and
more im
provement w
ork
30Potential A
reas Ripe for Action
Possible improvem
ent areas that have been generated
as a result of C
MS goals and
priorities include the
following:
XW
orkforce Burden Reduction
XIm
prove Behavioral Health, including O
pioid A
buseX
Improve Public Health, includ
ing Obesity Red
uctionX
Increase Patient SafetyX
Increase Q
uality of C
are TransitionsX
Long Term C
are
--Special Attention to Rural A
merica --
Contracting
Overview
PHYLLIS LEW
IS, CM
S DIREC
TOR, D
IVISIO
N O
F QUA
LITY CO
NTRA
CTS,
OA
GM
KIM TA
TUM, C
MS C
ON
TRAC
TING
OFFIC
ER, OA
GM
GREG
GESTERLIN
G, C
MS C
ON
TRAC
TOR C
OM
PLIAN
CE O
FFICER
32C
ontracting Overview
XRem
inder: this event is an op
en exchange w
ith industry and
no answ
ers given will be consid
ered
official or binding on the part of
the government
33W
hat is the NQ
IIC ID
IQ contract
structure?
XM
ultiple-awa
rd ID
IQ contracting
X“Um
brella” contra
cts to be established
with
multiple vend
ors
XFull a
nd open com
petition
XFa
ir Opportunity
XC
ost will be eva
luated
34N
QIIC
contractors under the ID
IQ
X“M
ini” competition for ID
IQ contra
ct hold
ersX
NQ
IIC ID
IQ w
ill encompass a
broad
er outrea
ch of work.
XO
fferors are not required
to propose on a
ll program
s. X
Period of Perform
ance und
er task ord
er aw
ard
s.
35Task O
rder C
ontract Types
FAR 16.5 a
uthorizes the use of any
appropriate cost or pricing arrangem
ent:X
Fixed-price C
ontracts
XC
ost-Reimbursem
ent Contracts
XIncentive C
ontracts X
Time-and
-ma
terials and Labor-hour
Contracts
XO
ption periods
36A
cquisition Schedule (1 of 2)
IDIQ
Aw
ard Sched
uleX
04/2018 –Release RFP in Fed
bizOpps
X04/2018 –
Preproposal Conference
X06/2018 –
Proposals D
ueX
08/17/18 –N
egotiationsX
12/2018 –A
wa
rd IDIQ
Contract
37A
cquisition Schedule (2 of 2)
Task Ord
er 0001 Aw
ard Sched
ule:X
12/2018 –Release RFP to ID
IQ
contractors
X1/2019 –
Preproposal C
onferenceX
2/2019 –Proposa
ls ReceivedX
4/2019 –N
egotiations X
7/2017 –A
wa
rd Ta
sk Ord
ers
38Q
IN 12
thSOW
Task Ord
er
XO
ne task order per aw
ard
eeX
No d
efining regionsX
Ensure fungibility where possible
across tasks and ta
sk order
XM
inimum
two states proposed
39C
onflict of Interest
XG
eneral conflicts
XSta
tutory Requirements
BREAK –
20 minutes
Question Response
CM
S LEAD
ERSHIP REPRESENTA
TIVES
42Q
uestions for Industry D
ay Participants
XC
ontract type/vehiclea
. Is your organization interested
in pursuing work
under the new
NQ
IIC ID
IQ contract structure?
b. Which w
ork type or work types you are interested
in perform
ing?X
What w
ould incentivize your organization to submit a
proposal?X
What are the three highest priorities/desired outcom
es for future quality im
provement efforts that your
organization is ideally configured to generate?a. A
t what scale are you prepared
to work?
43Q
uestions for Industry D
ay Participants
XW
hat do you recomm
end and what innovative approaches have
you employed to address w
orkforce burden reduction?X
What innovative considerations/recom
mendations do you have
regarding structure, scale and scope of individual Quality
Improvem
ent Task Orders?
a. Wha
t innovative ideas d
o you have or has your organization
begun to test that could generate significant results?
XW
hat measures and m
easures systems do you m
ost recomm
end for us to track the im
provement from
our quality work?
XFor Q
IN-Q
IO Task O
rders that require geographic coverage: What
factors are important to you w
hen proposing to cover a geographic area of the country? W
hat suggestions do you have in structuring task orders to allow
for greatest flexibility and cost efficiencies?
Next Steps
45N
ext Steps
XSubm
it feedba
ck on RFI questions by O
ctober 19 no later tha
n 4 pm ea
stern to N
QIIC
@cm
s.hhs.govX
Any new
informa
tion about these solicitations w
ill be ava
ilable on
FBO.gov
46
Thank you!N
QIIC
@C
MS.HHS.G
OV