Clinician Quality Improvement Program

Also known as CQIP

As one of the 59 Clinician Quality Improvement Contractors (CQIC) designated by CMS, the New Jersey Innovation Institute's Healthcare Division will provide expert advisory services and resources to help physicians and other practitioners improve quality of care, customer experience and patient outcomes.

Who is this program for?

Subject to final program details as defined by CMS, this program is likely  to be open for participation to independent clinicians, Federally Qualified Health Centers (FQHCs), Accountable Care Organizations (ACOs), faculty practices, clinically integrated networks, patient-centered medical homes (PCMH), Comprehensive Primary Care (CPC+) and Primary Care participants, as well as independent physician associations.

There is no fee to participate, but it is likely you will have to be practicing in New Jersey, Puerto Rico, Pennsylvania, or Delaware.

What is involved?

Participants must commit to meeting at least one of the four aims of the program, as well as improving patient and family engagement. They must also participate in monthly data submission on select quality improvement measures. Below are details on the four aims of the program:

+Aim 1 – Improve behavioral-health outcomes, including a focus on decreased opioid misuse.

  • Decrease opioid-related adverse events (including deaths) by 7%, with focus on the Medicare population.

  • Decrease opioid prescribing (for prescriptions > 90 morphine milligram equivalents daily) across outpatient facilities by 12%.

  • Increase access to behavioral health services by 15.7%, including access to care for those who need mental health services but are not receiving them.

+Aim 2 – Focus on patient safety and reducing all-cause harm including medication documentation, high-risk medications, dementia safety concerns, and antibiotic stewardship.

  • Reduce all-cause harm in hospitals by 10%.

  • Reduce readmissions by 5.4%.

  • Reduce Adverse Drug Events (ADEs) in community settings serving high-risk Fee-for-Service Medicare beneficiaries by 6.5%.

  • Reduce the rate of ADEs by 7.8% in clinical practices.

  • Reduce hospitalizations for community-onset Clostridium difficile infection by 6.5% based on 50% reduction of inappropriate antibiotic prescribing.

  • Increase antibiotic stewardship programs in outpatient settings by 6.5%.

+Aim 3 – Chronic disease management and prevention (cardiac and vascular health, diabetes, and kidney disease).

  • Achieve at least 80% performance on the ABCS clinical quality measures (Aspirin as appropriate, Blood pressure control, Cholesterol management and Smoking cessation).

  • Achieve at least 48.3% participation initiation rates among those eligible for cardiac rehabilitation.

  • Assist practices in the adoption of electronic and clinical workflows that establish home or out-of-office blood pressure monitoring for hypertensive patients.

  • Achieve a 13.8% reduction in smoking prevalence among Medicare beneficiaries treated by targeted clinicians.

  • Prevent Medicare beneficiaries from developing diabetes.

  • Improve management of diabetes for Medicare beneficiaries.

  • Screen, diagnose, and manage individuals with chronic kidney disease (CKD) to prevent progression to end-stage renal disease by identifying patients at high risk for developing kidney disease and improving outcomes for those patients.

+Aim 4 – Improve community-based care transitions to reduce hospital admission.

  • Improve community-based care transitions to reduce hospital admissions by 4.1% and readmissions by 5.4% nationally.

  • Monitor access to care that leads to hospital utilization.

  • Reduce potentially avoidable admissions, readmissions and super-utilization in Medicare Advantage beneficiaries.

Where are we in the process?

The CQIP program is pending final award.

NJII is one of the 59 awardees across the country that CMS deemed eligible to bid on work under the Network of Quality Improvement and Innovation Contractors program.

When did the program launch and what is its timeline?

Once awarded, this initiative will be a five-year program. We expect work to begin in early 2020.

Why participate?

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There is no cost to participate. Clinicians who participate are likely to receive the following:

 Exact benefits of the program are subject to the final details of the program when awarded.

Why work with NJII?

  • Our team has a proven track record, our Garden Practice Transformation Network (GPTN) included 12,000+ physicians who collectively saved $180 million over the course of four years and moved the needle on more than 40 quality measures (read full article)

  • NJII has a team of experienced and qualified improvement analysts, many of whom have been (or still are) practitioners in their own right

  • Our technology team has a working knowledge of more than 60 clinician source systems and will provide tailored support to help pull data out of your EHR, practice management, and population health management systems for analysis and reporting on performance improvements

  • Our team, environment, processes and systems are 100% HIPAA compliant and follow HIPAA rules and guidelines for protecting and securing PHI

  • We are the designated operator of the state-wide NJHIN, and can help you connect and gain access to those services

  • We can provide you with direct access to revenue stream generating opportunities available through value-based programs and APMs

  • Our team is both flexible and accommodating, and understands the importance of minimizing the burden of these activities. They will work with you on your terms, whether that means helping you create reports in your EHR, documenting metrics on paper, or meeting outside normal business hours. 

  • We are committed to demonstrating the return-on-investment we bring, at every step

  • We have a 7-year history of success with the Physician Quality Reporting System (PQRS), as well as Meaningful Use and MIPS reporting services via our CMS-certified registry. We can help eligible participants minimize their penalties and maximize their incentives

  • We are also the partner organization tasked with helping eligible practices in New Jersey satisfy the requirements of the Medicaid Promoting Interoperability Program (formerly known as Meaningful Use or the EHR Incentive Program) and have helped more than 1,500 clinicians earn $19.9 million in incentives during the past four years. So, we can make sure that the work you are doing in this program transfers, where applicable

  • We are well versed in clinical quality measure selection with experience monitoring and reporting on MIPS, DSRIP, Medicare Shared Savings (MSSP) Bundled Payment for Care Improvement Advanced (BPCI-Advanced), CPC+ and Healthcare Effectiveness Data and Information Set (HEDIS)

How can I participate?

This work will being in early 2020 pending a contract award from CMS. Complete a simple questionnaire to pre-enroll and we will contact you when we are ready to begin work.

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