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Working for Quality > About the NQS > National Quality Strategy: Overview

National Quality Strategy: Overview


This set of 32 PowerPoint slides provides essential background about the NQS. Each slide includes notes that you can access by selecting “View” and then “Notes Page” in PowerPoint.

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Overview

Contents

1: National Quality Strategy: Overview
2. Background on the National Quality Strategy
3. The strategy is to concurrently pursue three aims:
4. The Relationship Between the IHI Triple Aim and NQS Three Aims
5. National Quality Strategy: How It Works
6. National Quality Strategy: How It Works (Stakeholder Types)
7. The national quality strategy priorities
8. National Quality Strategy: How It Works (Priorities)
9. Priority 1: Making care safer by reducing harm caused in the delivery of care
10. Priority 2: Ensuring that each person and family members are engaged as partners in their care
11. Priority 3: Promoting effective communication and coordination of care
12. Priority 4: Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease
13. Priority 5: Working with communities to promote wide use of best practices to enable healthy living
14. Priority 6: Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models
15. The national quality strategy levers
16. National Quality Strategy: How It Works (Levers)
17. The National Quality Strategy Levers
18. Measurement and Feedback
19. Public Reporting
20. Learning and Technical Assistance
21. Certification, Accreditation, and Regulation
22. Consumer Incentives and Benefit Designs
23. Payment
24. Health Information Technology
25. Innovation and Diffusion
26. Workforce Development
27. National Quality Strategy: How It Works (The Three Aims)
28. Highlighted Initiatives
29. Highlighted Initiatives (continued)
30. Ongoing Implementation Activities
31. Annual Progress Report
32. For more information:


1: National Quality Strategy

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Overview

September 2014

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2: Background on the National Quality Strategy

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  • Established by the Affordable Care Act to improve the delivery of health care services, patient health outcomes, and population health.
  • The Strategy was first published in 2011 and serves as a nationwide effort to improve health and health care across America .
  • The Strategy was iteratively designed by public and private stakeholders and provides an opportunity to align quality measures and quality improvement activities.

Note: The National Quality Strategy was established in 2011 as part of the Affordable Care Act. More than 300 stakeholder offered input into this national strategy to align quality measures and quality improvement activities.

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3: The strategy is to concurrently pursue three aims:

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Image of a Venn diagram with "Better Health" as the top circle; a circle with "Better Care" at bottom left; and a circle with "Lower Costs" at bottom right.

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  • Through the Better Care aim, the Strategy pursues improvement to the overall quality of health care by making health care more patient-centered, reliable, accessible and safe.
  • Through the Healthy People/Healthy Communities aim, the Strategy guides the nation in improving population health by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.
  • And through the Affordable Care aim, the Strategy seeks to reduce the cost of quality health care for individuals, families, employers, and government.

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4: The Relationship Between the IHI Triple Aim and NQS Three Aims

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Slide shows the logos for the IHI Triple Aim and the National Quality Strategy. The IHI Triple Aim shows a triangle. Above the top point are the words "Improving the patient experience of care (including quality and satisfaction)". On the left-hand point are the words: "Improving the health of populations". The right-hand point has the words "Reducing the per capita cost of health care".

The National Quality Strategy side shows the following aims:

Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.

Healthy People/Healthy Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social and, environmental determinants of health.

Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government.

Note: These aims will be used to guide local, State, and national efforts to improve health and the quality of health care. The National Quality Strategy's three aims closely resemble IHI's Triple Aim, and it builds on the work that IHI has done by giving additional consideration to the health of communities at different levels and affordability for multiple groups.

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5: National Quality Strategy: How It Works

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Slide shows the logos for "Stakeholder Types", "Priorities", "Levers", "The Three Aims"

The Stakeholder Types shows the following: States; Federal and HHS; Private Sector and Multi Stakeholder Groups

The Priorities shows the "Six quality concerns that affect most Americans" and are the following: Patient Safety, Person-and-Family Centered Care, Effective Communication and Care Coordination, Prevention and Treatment of Leading Causes of Mortality, Health and Well-Being and Affordable Care.

The Levers shows the "The Core business functions, resources, and/or actions that may serve as a means for achieving improved health and health care quality" and are the following: Measurement and Feedback; Public Reporting; Learning and Technical Assistance; Certification, Accreditation and Regulation; Consumer Incentives and Benefits Designs; Payment; Health Information Technology; Innovation and Diffusion and Workforce Development.

The The Three Aims shows the image of a circle with "Better Health" at the top, and a circle with "Better Care" at bottom left and a circle with "Lower Costs" at bottom right.

The National Quality Strategy unites efforts to improve health and health care for all Americans. The above graphic provides a high-level view of how the National Quality Strategy works to provide better, more affordable care for the person and the community.

Note: Here is a high-level look at how the National Quality Strategy works, moving from left to right.

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6: National Quality Strategy: How It Works (Stakeholder Types)

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Slide shows the logos for "Stakeholder Types"

The Stakeholder Types shows the following: States; Federal and HHS; Private Sector and Multi Stakeholder Groups

The National Quality Strategy unites efforts to improve health and health care for all Americans. The above graphic provides a high-level view of how the National Quality Strategy works to provide better, more affordable care for the person and the community.

Note: Implementation of the National Quality Strategy involves action on the part of stakeholders at the federal, state, and local levels within both the public and private sectors. Everyone has a role to play, and we can only move towards a better health care system through cooperation and collaboration.

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7: The National Quality Strategy Priorities

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The National Quality Strategy Priorities

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8: National Quality Strategy: How It Works

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Slide shows the logos for "Stakeholder Types" and "Priorities" with emphasis on "Priorities"

The Priorities shows the "Six quality concerns that affect most Americans" and are the following: Patient Safety, Person-and-Family Centered Care, Effective Communication and Care Coordination, Prevention and Treatment of Leading Causes of Mortality, Health and Well-Being and Affordable Care.

The National Quality Strategy unites efforts to improve health and health care for all Americans. The above graphic provides a high-level view of how the National Quality Strategy works to provide better, more affordable care for the person and the community.

Note: The National Quality Strategy priorities reflect the quality concerns that affect most Americans. The priorities address patient safety, effective communication and care coordination, person and family centered care, prevention and treatment of leading causes of mortality, affordable care and health/well-being.

The National Quality Strategy's six priorities are based on the latest research, input from a broad range of stakeholders, and examples from around the country. These priorities can be achieved only with the active engagement of clinicians, patients, provider organizations, and many others in local communities across the country— something the National Quality Strategy supports. Since different communities have different assets and needs, they will likely take different paths to achieving the six priorities.

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9: Priority 1: Making care safer by reducing harm caused in the delivery of care

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Long-Term Goals

  1. Reduce preventable hospital admissions and readmissions.
  2. Reduce the incidence of adverse health care-associated conditions.
  3. Reduce harm from inappropriate or unnecessary care.

Note: The National Quality Strategy has identified three long-term goals related to patient safety: reduce preventable hospital admissions and readmissions, reduce the incidence of adverse health care-associated conditions, and reduce harm from inappropriate or unnecessary care.

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10: Priority 2: Ensuring that each person and family members are engaged as partners in their care

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Long-Term Goals

  1. Improve patient, family, and caregiver experience of care related to quality, safety, and access across settings.
  2. In partnership with patients, families, and caregivers—and using a shared decision-making process—develop culturally sensitive and understandable care plans.
  3. Enable patients and their families and caregivers to navigate, coordinate, and manage their care appropriately and effectively.

Note: Person-centered care means defining success not just by the resolution of clinical symptoms but also by whether patients achieve their desired outcomes. Some examples of person-centered care could include ensuring that patients' preferences, desired outcomes, and experiences of care are integrated into care delivery; integrating patient-generated data in electronic health records; and finding additional ways to involve patients and families in managing their care effectively.

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11: Priority 3: Promoting effective communication and coordination of care

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Long-Term Goals

  1. Improve the quality of care transitions and communications across care settings.
  2. Improve the quality of life for patients with chronic illness and disability by following a current care plan that anticipates and addresses pain and symptom management, psychosocial needs, and functional status.
  3. Establish shared accountability and integration of communities and health care systems to improve quality of care and reduce health disparities.

Note: When all of a patient's health care providers coordinate their efforts, it helps ensure that the patient receives appropriate care and support, when and how the patient needs and wants it. Effective care coordination models, such as patient-centered medical homes, have begun to show that they can deliver better quality care at lower costs in settings that range from small physician practices to large hospital centers.

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12: Priority 4: Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease

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Long-Term Goals

  1. Promote cardiovascular health through community interventions that result in improvement of social, economic, and environmental factors.
  2. Promote cardiovascular health through interventions that result in adoption of the most healthy lifestyle behaviors across the lifespan.
  3. Promote cardiovascular health through receipt of effective clinical preventive services across the lifespan in clinical and community settings.

Note: Improving the quality of American health care demands an intense focus on preventing and treating cardiovascular disease. The lessons from this effort will feed into efforts addressing conditions such as HIV/AIDS and other chronic illnesses. Future initiatives will address a broad range of diseases and age ranges.

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13: Priority 5: Working with communities to promote wide use of best practices to enable healthy living

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Long-Term Goals

  1. Promote healthy living and well-being through community interventions that result in improvement of social, economic, and environmental factors.
  2. Promote healthy living and well-being through interventions that result in adoption of the most important healthy lifestyle behaviors across the lifespan.
  3. Promote healthy living and well-being through receipt of effective clinical preventive services across the lifespan in clinical and community settings.

Note: The broad goal of promoting better health is one that is shared across the country, whether it's promoting healthy behaviors, such as not using tobacco, or fostering healthy environments that make it easier to exercise and get access to healthy foods. For that reason, successful efforts to improve these health factors rely on deploying evidence-based interventions through strong partnerships between local health care providers, public health professionals, and individuals.

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14: Priority 6: Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models

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Long-Term Goals

  1. Ensure affordable and accessible high-quality health care for people, families, employers, and governments.
  2. Support and enable communities to ensure accessible, high-quality care while reducing waste and fraud.

Note: The National Quality Strategy recognizes that while this will be a challenge, the goal of reducing health care costs is important to everyone because of the impact of rising costs on families, employers, and State and Federal governments. Reducing costs must be considered hand-in-hand with the aims of better care, healthier people and communities, and affordable care.

The National Quality Strategy will foster strategies that reduce waste from undue administrative burdens and make health care costs and quality more transparent to consumers and providers, so they can make better choices and decisions.

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15: The National Quality Strategy Levers

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The National Quality Strategy Levers

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16: National Quality Strategy: How It Works

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Slide shows the logos for "Stakeholder Types", "Priorities" "Levers" and "The Three Aims" with emphasis on "Levers"

The Levers show the "The Core business functions, resources, and/or actions that may serve as a means for achieving improved health and health care quality" and are the following: Measurement and Feedback; Public Reporting; Learning and Technical Assistance; Certification, Accreditation and Regulation; Consumer Incentives and Benefits Designs; Payment; Health Information Technology; Innovation and Diffusion and Workforce Development.

The National Quality Strategy unites efforts to improve health and health care for all Americans. The above graphic provides a high-level view of how the National Quality Strategy works to provide better, more affordable care for the person and the community.

Note: Here is a high-level look at how the National Quality Strategy works.

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17: The National Quality Strategy Levers

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The Strategy's aims and priorities are supported by the nine National Quality Strategy "levers": organizations' core business functions that serve as a means for improving health and health care quality.

Slide shows a scale with the the nine National Quality Strategy "levers" on the left weigh down the "The Three Aims" on the right with "Image of a circle with "Better Health" at the top, and a circle with "Better Care" at bottom left and a circle with "Lower Costs" at bottom right.

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18: Measurement and Feedback

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The slide shows the logo for the "Measurement and Feedback" lever, and underneath the loo are the words: "Provide performance feedback to plans and providers to improve care". It points to a text box which says: "A long-term care provider may implement a strategy that includes the use of Quality Assurance and Performance Improvement data to populate measurement dashboards for purposes of identifying and addressing areas requiring quality improvement"

Note: The Measurement and Feedback lever is designed to provide performance feedback to plans and providers to improve care. For example, a long-term care provider may implement a strategy that includes the use of Quality Assurance and Performance Improvement data to populate measurement dashboards for purposes of identifying and addressing areas requiring quality improvement.

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19: Public Reporting

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The slide shows the logo for the "Public Reporting" lever. Underneath the logo are the words:
"Compare treatment results, costs, and patient experience for consumers". To the right of that is a text box with the words: "A regional collaborative may ask member hospitals and medical practices to align public reports to the National Quality Strategy aims or priorities"

Note: The public reporting lever was designed to compare treatment results, costs, and patient experience for consumers. For example, a regional collaborative may ask member hospitals and medical practices to align public reports to the National Quality Strategy aims or priorities.

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20: Learning and Technical Assistance

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The slide shows the logo for the "Learning and Technical Assistance" lever. Underneath are the words: "Foster learning environments that offer training, resources, tools, and guidance to help organizations achieve quality improvement goals". To the right is a text box with the words: "A Quality Improvement Organization may disseminate evidence-based best practices in quality improvement with physicians, hospitals, nursing homes, and home health agencies."

Note: The Learning and Technical Assistance lever fosters learning environments that offer training, resources, tools, and guidance to help organizations achieve quality improvement goals. For example, a Quality Improvement Organization may disseminate evidence-based best practices in quality improvement with physicians, hospitals, nursing homes, and home health agencies.

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21: Certification, Accreditation, and Regulation

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The slide shows the logo for the "Certification, Accreditation, and Regulation" lever. Underneath are the words: "Adopt or adhere to approaches to meet safety and quality standards". To the right is a text box with the words: "The National Quality Strategy aims and priorities may be incorporated into continuing education requirements or certification maintenance".

Note: The Certification, Accreditation, and Regulation lever suggests that organizations adopt or adhere to approaches to meet safety and quality standards. For example, the National Quality Strategy aims and priorities may be incorporated into continuing education requirements or certification maintenance.

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22: Consumer Incentives and Benefit Designs

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The slide shows the logo for the "Consumer Incentives and Benefit Designs" lever. Underneath are the words: "Help consumers adopt healthy behaviors and make informed decisions". To the right is a text box with the words: "Employers may implement workforce wellness programs that promote prevention and provide incentives for employees to improve their health".

Note: The Consumer Incentives and Benefit Designs lever was designed to help consumers adopt healthy behaviors and make informed decisions. For example, Employers may implement workforce wellness programs that promote prevention and provide incentives for employees to improve their health.

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23: Payment

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The slide shows the logo for the "Payment" lever. Underneath are the words: "Reward and incentivize providers to deliver high-quality, patient-centered care". To the right is a text box with the words: "Join a coalition of purchasers that are pursuing value-based strategies".

Note: The payment lever was designed to reward and incentivize providers to deliver high-quality, patient-centered care. For example, organizations may consider joining a coalition of purchasers that are pursuing value-based strategies.

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24: Health Information Technology

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The slide shows the logo for the "Health Information Technology" lever. Underneath are the words: "Improve communication, transparency, and efficiency for better coordinated health and health care". To the right is a text box with the words: "A hospital or medical practice may adopt an electronic health record system to improve communication and care coordination".

Note: The Health Information Technology lever was designed to improve communication, transparency, and efficiency for better coordinated health and health care. For example, a hospital or medical practice may adopt an electronic health record system to improve communication and care coordination.

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25: Innovation and Diffusion

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The slide shows the logo for the "Innovation and Diffusion" lever. Underneath are the words: "Foster innovation in health care quality improvement, and facilitate rapid adoption within and across organizations and communities". To the right is a text box with the words: "Center for Medicare & Medicaid Innovation tests various payment and service delivery models and shares successful models across the Nation".

Note: The innovation and diffusion lever was designed to foster innovation in health care quality improvement, and facilitate rapid adoption within and across organizations and communities. For example, the Center for Medicare & Medicaid Innovation tests various payment and service delivery models and shares successful models across the Nation.

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26: Workforce Development

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The slide shows the logo for the "Workforce Development" lever. Underneath are the words: "Investing in people to prepare the next generation of health care professionals and support lifelong learning for providers". To the right is a text box with the words: "A medical leadership institution may incorporate quality improvement principles in their training".

Note: The Workforce Development lever encourages investment in people to prepare the next generation of health care professionals and support lifelong learning for providers. For example, a medical leadership institution may incorporate quality improvement principles in their training.

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27: National Quality Strategy: How It Works

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Slide shows the logos for "Stakeholder Types", "Priorities" "Levers" and "The Three Aims" with emphasis on "The Three Aims"

The The Three Aims shows the image of a circle with "Better Health" at the top, and a circle with "Better Care" at bottom left and a circle with "Lower Costs" at bottom right..

The National Quality Strategy unites efforts to improve health and health care for all Americans. The above graphic provides a high-level view of how the National Quality Strategy works to provide better, more affordable care for the person and the community.

Note: And finally, after the stakeholders decide which priorities to focus on, what levers to pull to achieve action, we arrive at the three aims of better care, healthy people and healthy communities, and more affordable quality care.

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28: Highlighted Initiatives

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NQS Priority Highlighted Initiative Web Site
1. Making care safer by reducing harm caused in the delivery of care. Partnership for Patients. http://partnershipforpatients.cms.gov/
2. Ensuring that each person and family members are engaged as partners in their care. Consumer Assessment of Healthcare Providers and Systems (CAHPS). http://www.cms.gov/Hospital-Value-Based-Purchasing
3. Promoting effective communication and coordination of care. Multi-payer Advanced Primary Care Practice Demonstration (MAPCP). http://innovation.cms.gov/initiatives/Multi-Payer-Advanced-Primary-Care-Practice/
4. Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease. Million Hearts. http://www.millionhearts.hhs.gov

Notes:

  • Partnership for Patients: a national campaign to reduce preventable hospital-acquired conditions and 30-day hospital readmissions.
  • Consumer Assessment of Healthcare Providers and Systems (CAHPS): a survey that asks consumers and patients to report on and evaluate their experiences with health care.
  • The Multi-Payer Advance Primary Care Practice Demonstration (MAPCP): a multi-payer collaboration to transform primary care practices around quality outcomes.
  • The Million Hearts Campaign: a national effort to prevent 1 million heart attacks and strokes by 2017.

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29: Highlighted Initiatives (continued)

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NQS Priority Highlighted Initiative Web Site
5. Working with communities to promote wide use of best practices to enable healthy living. Community Transformation Grants (CTG). http://www.cdc.gov/communitytransformation/
6. Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models. CMS Innovation Center. http://www.innovations.cms.gov

Notes:

  • Community Transformation Grants (CTG): these grants support community-level efforts to reduce chronic diseases such as heart disease, cancer, stroke, and diabetes.
  • The CMS Innovation Center: this center supports new models of care and innovative practices for Medicare, Medicaid, and CHIP beneficiaries, with the goal of improving the quality of health care while maintaining or reducing costs.

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30: Ongoing Implementation Activities

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  • Annual meetings of the Interagency Working Group on Health Care Quality, including senior representatives from 24 Federal Agencies.
  • Annual updates to the Agency-Specific Plans developed by HHS operating divisions, which are available on the Working for Quality Web site.
  • Active engagement of stakeholders in the dissemination of the National Quality Strategy through the National Quality Partners and the Measure Application Partnership.
  • Publication of toolkits and presentations for use by community partners.
  • The Priorities in Action series, which offers a snapshot of some of our Nation's most promising and transformative quality improvement programs and describes their alignment to the NQS' six priorities (updated monthly, these programs represent private sector, Federal, State, and local efforts).

Note: The Interagency Working Group on Health Care Quality includes leaders from 24 Federal departments and Agencies. These 24 departments and agencies have missions related to health care and quality improvement. The Working Group provides an ongoing opportunity for collaboration across Federal programs, facilitates shared learning, and helps avoid duplicative efforts.

Each HHS agency develops an Agency-Specific Plan to describe how it is supporting National Quality Strategy priorities and implementation (as required by the ACA legislation). The National Priorities Partnership is a collaborative of major health care stakeholders that sets national priorities and goals for improving health care quality throughout the country, in all settings. Its membership includes a wide variety of stakeholders, including consumer organizations, public and private purchasers, physicians, nurses, hospitals, and health research organizations.

The Measures Application Partnership is a multi-stakeholder group that provides ongoing, detailed analysis of measures being considered for use in Federal public reporting and performance-based payment programs. The Measures Application Partnership ensures these measures are aligned with the National Quality Strategy aims and priorities, and it fosters the use of these measures across the private sector. The Priorities in Action series offers a snapshot of some of our nation's most promising and transformative quality improvement programs, and describes their alignment to the NQS' six priorities. Updated monthly, these programs represent private sector, Federal, State, and local efforts.

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31: Annual Progress Report

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  • Starting in 2015, the National Quality Strategy Annual Progress Report will rely on the Agency for Healthcare Research and Quality's National Healthcare Quality and Disparities Reports to highlight the Nation's quantitative performance on the National Quality Strategy aims and priorities.
  • Future updates to the National Healthcare Quality and Disparities Reports will include updated measurement data tracking the Nation's progress on each priority. Current measurement data can be found on the National Health Care Quality and Disparities Web site at http://www.ahrq.gov/research/findings/nhqrdr/index.html.
  • This comprehensive update on quality improvement will draw much-needed attention to the state of health and health care quality in the United States, including opportunities for continued improvement and successes achieved.

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32: For more information:

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Note: Thank you.

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