[Federal Register Volume 79, Number 249 (Tuesday, December 30, 2014)]
[Notices]
[Pages 78440-78442]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-30447]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-3300-FN]
RIN 0938-ZB15


Medicare Program; Evaluation Criteria and Standards for Quality 
Improvement Networks Quality Improvement Program Contracts; Base and 
Task Orders

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

[[Page 78441]]


ACTION: Final notice.

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SUMMARY: This final notice announces the general criteria we will use 
to evaluate the effectiveness and efficiency of Quality Innovation 
Network (QIN) Quality Improvement Organizations (QIOs) that entered 
into contracts with CMS under the 11th Statement of Work (SOW) in July 
2014. (The activities for the QIN-QIO SOW began August 1, 2014). In 
addition, this notice addresses public comments on the August 11, 2014 
notice with comment period entitled, ``Evaluation Criteria and 
Standards for Quality Improvement Networks Quality Improvement Program 
Contracts [Base and Task Order(s)]''

DATES: Effective Dates: August 1, 2014 to July 31, 2019.

FOR FURTHER INFORMATION CONTACT: Alfreda Staton, (410) 786-4194.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 1153(h)(2) of the Social Security Act (the Act) requires 
the Secretary of the Department of Health and Human Services (the 
Secretary) to publish in the Federal Register the general criteria and 
standards that will be used to evaluate the effective and efficient 
performance of contract obligations by the Quality Improvement 
Organizations (QIOs), and to provide the opportunity for public comment 
with respect to these criteria and standards.

II. Provisions of the Notice With Comment Period

    On August 11, 2014, we published a notice with comment period in 
the Federal Register (79 FR 46830 through 46835) entitled, ``Evaluation 
Criteria and Standards for Quality Improvement Networks Quality 
Improvement Program Contracts [Base and Task Order(s)]'' to announce 
the general criteria that we would use to evaluate performance of the 
Quality Innovation Network (QIN)--QIOs under the QIN-QIO 11th Statement 
of Work (SOW) contract beginning August 1, 2014. (Solicitation Number: 
HHSM-500-2014-RFP-QIN-QIO). That notice summarized the tasks of the 
QIN-QIOs and the criteria to be used for annual performance evaluations 
during the 5-year term of the contract.
    The evaluation of a QIN QIO's performance related to their SOW will 
be based on evaluation criteria specified for the tasks and subtasks 
set forth in Section C.5 of the QIN-QIO Base Contract and Attachment J-
1(b) of the QIN-QIO Task Order. The general criteria that will be used 
to evaluate the QIN-QIOs under the QIN-QIO 11th SOW contract beginning 
August 1, 2014, include performance of the following Tasks:
     Improving Cardiac Health and Reducing Cardiac Healthcare 
Disparities.
     Reducing Disparities in Diabetes Care.
     Improving Prevention Coordination through Meaningful Use 
of Health Information Technology (HIT) and Collaborating with Regional 
Extension Centers (RECs).
     Reducing Healthcare-Associated Infections in Hospitals.
     Reducing Healthcare-Acquired Conditions in Nursing Homes.
     Improving Coordination of Care, Quality Improvement 
through Value-Based Payment, Quality Reporting, and the Physician 
Feedback Reporting Program.
     Quality Improvement Initiatives.
    The Table at Attachment J.1(b) of the SOW lists performance 
measures by the following Tasks:
     B.1. Improving Cardiac Health
     B.2. Everyone with Diabetes Counts
     B.3. (Reserved)
     B.4. Meaningful Use of HIT and Collaborating With RECs
     C.1. Reducing Healthcare-Acquired Infections (HAIs) in 
Hospitals
     C.2. Reducing Healthcare-Acquired Conditions in Nursing 
Homes
     C.3. Coordination of Care
     D.1. Quality Improvement through Physician Value-Based 
Modifiers
     E.1. Technical Assistance--Quality Improvement Initiatives 
(QIIs)
    Evaluation Criteria. Annual (12, 24, 36, 48th month) and 54th month 
Evaluation Criteria are defined in Attachment J-1(b) of the QIN-QIO 
SOW.
    Additional details provided in the notice are posted at: http://www.gpo.gov/fdsys/pkg/FR-2014-08-11/pdf/2014-18901.pdf.

III. Analysis of and Responses to Public Comments on the Notice With 
Comment Period

    A commenter affiliated with a private healthcare quality 
improvement entity submitted several comments concerning the general 
criteria we would use to evaluate the effectiveness and efficiency of 
QIN-QIOs that entered into contracts with CMS under the 11th SOW.
    A summary of the comments and our responses are as follows:
    Comment: The commenter expressed appreciation for the opportunity 
to submit comments on the general evaluation criteria and standards and 
noted the importance of the three-part aim in the QIN-QIO SOW of better 
health, better healthcare, and lower costs through improved quality for 
Medicare enrollees. The commenter suggested that CMS continue its 
efforts to assess the effectiveness of the QIN-QIOs using measures of: 
improved patient quality and safety, improved population health, 
reduction of avoidable costs, engagement of patients, families and 
consumers in care and population health improvement and improved 
coordination of care and integrative services.
    Response: We agree with the commenter that the QIN-QIO contract and 
the general evaluation criteria and standards focus on strategic 
initiatives including the three part aim and the projects identified in 
the QIN-QIO Task Order support our goals of the three broad aims of 
better healthcare, better health, and lower healthcare costs through 
improvement for all Medicare beneficiaries. Measures for better 
healthcare include those for the Aim, Better Healthcare for 
Communities: Beneficiary-Centered, Reliable, Accessible, and Safe Care 
and includes measures for Tasks C.1 Reducing Healthcare-Associated 
Infections in Hospitals,C.2, Reducing Healthcare-Acquired Conditions in 
Nursing Homes, and C.3, Promote Effective Communication and 
Coordination of Care. Measures for the better health include those for 
the Aim, Healthy People, Healthy Communities: Improving the Health 
Status of Communities and include Tasks B.1, Improving Cardiac Health 
and Reducing Cardiac Healthcare Disparities, B.2, Reducing Disparities 
in Diabetes Care: Everyone with Diabetes Counts, and B.4, Improving 
Prevention Coordination through Meaningful Use of HIT and Collaborating 
with Regional Extension Centers. Measures for lower healthcare costs 
include Aim D, Better Care at Lower Cost and Task D.1, Quality 
Improvement through Value-Based Payment, Quality Reporting, and the 
Physician Feedback Reporting Program. These efforts will likely have a 
secondary effect of aiding in the transformation of the healthcare 
system.
    Comment: The commenter stated that CMS should provide QIN-QIOs with 
timely communication after award of the contract regarding operational 
and implementation issues that may arise over the 5-year period of 
performance.
    Response: We agree with the need for timely, systematic 
documentation of questions and answers to each QIN-QIO regarding all 
aspects of the SOW, including deliverables and the evaluation measures. 
We established an electronic system for submitting and documenting 
responses to contract performance concerns and questions;

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this system was made available to each of the QIN-QIOs.

IV. Comment Outside the Scope of the Notice

    A second commenter submitted a comment suggesting that CMS provide 
beneficiaries with an option to pay annually rather than only monthly 
for the Part D benefit. This comment is outside the scope of the notice 
of evaluation standards and criteria for the QIN-QIO SOW therefore, we 
are not providing a response to that comment.

V. Provisions of the Final Notice

    We have analyzed these comments and determined that it is 
appropriate to finalize without modification the provisions set forth 
in the August 11, 2014 notice with comment period entitled, 
``Evaluation Criteria and Standards for Quality Improvement Networks 
Quality Improvement Program Contracts [Base and Task Order(s)].'' (79 
FR 46830 through 46835).

VI. Collection of Information Requirements

    This document does not impose information collection requirements, 
that is, reporting, recordkeeping or third-party disclosure 
requirements. Consequently, there is no need for review by the Office 
of Management and Budget under the authority of the Paperwork Reduction 
Act of 1995.

VII. Regulatory Impact Statement

    In accordance with the provisions of Executive Order 12866, this 
notice was not reviewed by the Office of Management and Budget.

    Dated: November 19, 2014.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2014-30447 Filed 12-29-14; 8:45 am]
BILLING CODE 4120-01-P