The Right Care for Every Patient, Every Time.
Imagine a health care system where patients receive the right care every time, and where providers have the tools and resources to deliver that care. At Quality Insights of Pennsylvania, we spend every day working to make that health care system a reality.
Quality Insights of Pennsylvania is the Commonwealth’s Medicare Quality Improvement Organization (QIO). Our vision is to work with Pennsylvania’s health care providers to foster an environment in which every patient receives the right care every time and where care is safe, effective, patient-centered, timely, efficient, and equitable.
Quality Insights has begun work on the new three-year QIO contract, known as the 9th Scope of Work (9SOW). The 9SOW continues some of the themes introduced in the 8th Scope of Work (our last contract), while presenting new quality projects focused on providing the right care for every person, every time.
The main themes of the 9th Scope of Work include:
- Patient Safety
- Prevention
- Beneficiary Protection
Patient Safety Overview
The patient safety theme is also known as the CMS National Patient Safety Initiative (NPSI), Quality Insights will help heath care providers to work on six main topics:
- Reducing health care-associated Methicillin-resistant Staphyloccus aureus (MRSA) infections
- Reducing pressure ulcers in nursing homes and hospitals
- Reducing the use of physical restraints in nursing homes
- Improving inpatient surgical safety and heart failure treatment in hospitals
- Improving drug safety
- Providing quality improvement technical assistance to nursing homes in need
Beneficiary Protection Overview Continuing previous work as in the 8th Scope of Work, Quality Insights will carry out review activities such as:
- Reviewing the quality of care provided to beneficiaries
- Reviewing beneficiary appeals of certain provider notices
- Reviewing potential anti-dumping cases
- Implementing quality improvement activities as a result of case review activities
Prevention Overview Through the prevention theme, Quality Insights will help doctors use electronic health records for case management in order to ensure that beneficiaries receive all four preventative services that are especially important to Medicare. These four services are:
- Influenza immunizations
- Pneumococcal immunizations
- Mammography
- Colorectal Cancer Screening
We encourage you to explore this site to learn more.
