CMS Innovation Advisors Aim to Improve Quality of Care

The Centers for Medicare & Medicaid Services has tapped 73 healthcare professionals for its innovation advisors program. Funded with $6 million from the healthcare reform act, the program is designed to help drive improvements to patient care and help reduce healthcare costs. A second group of 120 advisors will be selected in June 2012.

The program, which is managed by the CMS Innovation Center, includes six months of orientation as well as in-person national and regional meetings, virtual training sessions, and seminars and presentations by healthcare experts. Each advisor will receive a stipend of about $20,000 to help cover the cost of transportation, lodging, and other expenses.

This first group of advisors includes clinicians, allied health professionals, health administrators, physicians and nurses from 27 states. Each one is required to develop a systems improvement project that will be scalable to other areas.

Julie Lewis, vice president of health policy and government relations for Amedisys, will look at care management for high risk elderly patients. Tina Schwien, quality improvement consultant at Qualis Health in Seattle, is developing a project to engage patients and their families to help reduce hospital acquired infections.

Lewis, who works out of Washington, D.C., says her project is an offshoot of some work she did with Jeffrey Brenner while she was at the Dartmouth Institute for Health Policy and Clinical Practice. Brenner, a New Jersey physician, formed the Camden Coalition of Healthcare Providers to provide care management for vulnerable populations in the city. Lewis plans to take that effort a few steps further to test if care management for high risk populations can be sustained and replicated across a larger population.

The project will be based in Louisiana where Amedisys, a home health and hospice company, is based. Plans call for a hospital-physician partnership that initially will treat 50 to 100 Medicaid, Medicare Advantage and indigent patients.

Reassigning care management responsibilities
In this case, innovation dictates how care is administered. Care management will be directed by providers, not by payers as is typically the case. "If a physician contracts with eight plans, that can mean dealing with eight care managers and that can make care coordination very difficult," Lewis explains. In measuring its success, Lewis says the project will look at utilization metrics, inpatient hospitalizations, and patient and caregiver experiences.

Lewis is committed to the innovation program for 12 months but expects her project to extend beyond that time period.

Reducing infections
Tina Schwien says her project will build on her work with quality improvement organizations. As she has looked at healthcare delivery she has become interested in how patients and their families, which she describes as "untapped resources" can be engaged to reduce the incidence of hospital-acquired infections. With a hospital partner, she will have to explore whether teaching families about the symptoms of infection will help identify potential problems more quickly.

Her project will focus on three common HAIs—surgical site, clostridium difficile, and catheter infections. The key she says will be to find "ways on a daily basis where the patient and family will be engaged in the process of reducing HAIs. That could be something as simple as remembering to wash their hands when they walk into the patient's room."

She hopes to identify steps to reduce infections that can be adapted and tailored to different hospitals. "I want this to become part of the hospital culture."

Schwien says participating in the innovation advisor's program is a great opportunity. "There is energy around the idea of innovation that this program captures. The time is right for sharing best practices."