TMF Health Quality Institute Wins QIO Contract

The TMF Health Quality Institute won the five-year Quality Innovation Network Quality Improvement Organization (QIN-QIO) contract with the Centers for Medicare & Medicaid Services (CMS) for Texas, Arkansas, Missouri, and Oklahoma.

"CMS has again recognized TMF as a leader in health care quality improvement with the award of a five-year, multistate contract to continue expanding the quality of care for Medicare beneficiaries," said David Fleeger, MD, chair of the TMF Board of Trustees and a member of the TMA Board of Trustees.

In May, CMS announced changes to its QIO program structure, including a multistate regional approach to replace state-specific QIOs for quality improvement work, designated the QIN-QIO Program. 

"TMF looks forward to expanding our quality improvement work throughout a larger region," said Tom Manley, TMF president and chief executive officer. "For more than 30 years, we have been dedicated to improving the quality of care for Medicare beneficiaries in Texas, and with our strong alliances throughout Arkansas, Missouri, and Oklahoma, we are ready to continue this important work.”

In January, TMA wrote a strong letter in support of TMF to Kathleen Sebelius, former secretary of the U.S. Department of Health and Human Services, and CMS Administrator Marilyn Tavenner. 

"The Texas Medical Association has longstanding policy in support of TMF Health Quality Institute as the statewide quality improvement organization of Texas. We support TMF as the sole quality improvement and peer review organization for state and federal programs and recognize TMF's due process and peer review for all health care programs in the state that are fully or partially funded by federal dollars," wrote then-TMA President Stephen L. Brotherton, MD. 

TMF's contract focuses on: 

  • Improving cardiac health and reducing cardiac health care disparities;
  • Reducing disparities in diabetes care;
  • Improving prevention efforts through meaningful use of health information technology;
  • Reducing infections in hospitals;
  • Reducing harm in nursing homes;
  • Assisting physicians and hospitals with quality reporting; and
  • Helping communities improve the coordination of health care for patients to help reduce unnecessary hospital readmissions.

The QIN-QIO contract award is the second phase of QIO program restructuring. CMS made major changes to the QIO program this year, electing to separate medical case review from quality improvement efforts.

In May, CMS announced the award of case review work, designated as the Beneficiary and Family-Centered Care QIO Program contract, to Ohio-based KePRO for Texas, 32 other states, and the District of Columbia. The organization will handle all Medicare case review activities in the designated regions starting Aug. 1.

Action, Aug. 1, 2014