A CLOSER LOOK
EDITORIAL ADVISOR : Chad T . Rodgers , MD , FAAP , CPE
Different name , same important work
Arkansas communities address health care challenges through the Partnership for Community Health project
MANDY PALMER , RN , CPHQ , CPPS - AFMC , DIRECTOR OF QUALITY
The Quality Improvement Organization ( QIO ) Program , led by the Centers for Medicare & Medicaid Services ( CMS ), is one of the largest federal programs dedicated to improving health quality at the community level for Medicare beneficiaries . Arkansas Foundation for Medical Care ( AFMC ) provides quality improvement assistance and expertise in Arkansas and Mississippi under contract with TMF Health Quality Institute , your state ’ s Quality Innovation Network-Quality Improvement Organization ( QIN- QIO ). The Partnership for Community Health project is part of this contract with CMS .
You may already be familiar working with the TMF QIN-QIO specialists on the Community Coalitions project . CMS recently made changes to the scope of that project , including changing the project name from Community Coalitions to the Partnership for Community Health . This change is meant to better reflect that it takes the community members working together to improve community health outcomes . We have updated page titles and links on our website , TMFNetworks . org , to reflect this name change .
A COMMUNITY BASED APPROACH
CMS has identified specific quality improvement initiatives for QIN-QIOs to address . Working with health care facilities and agencies , as well as with other state , local or community partner organizations , we implement quality improvement interventions to address :
• opioid use and misuse
• chronic disease management
• care coordination
• immunizations
THE CHALLENGES Opioid Utilization and Misuse involving
more than of those deaths
Why is our work necessary ? The statistics tell the story .
5 % of the total population of the country accounts for 50 % of U . S health care costs ($ 50,077 per person annually ).
68.4 % of Medicare beneficiaries have two or more chronic diseases and 36.4 % have four or more .
Pneumonia , a vaccine-preventable disease , is the top reason for almost 1 million hospital admissions among U . S . adults each year , second only to people giving birth .
According to the U . S . Department of Health and Human Services , more than 43,000 Medicare Part D beneficiaries suffered an opioid overdose in 2020 . What ’ s more , Medicare beneficiaries are especially vulnerable to opioid adverse drug events ( ADEs ) due to age-related metabolic changes and the health risks associated with polypharmacy , which is common to the Medicare population . Therefore , making sure this population has access to treatment and to overdose-reversal drugs is important .
Access to mental health services is also vital . According to the National Council for Behavioral Health and the Institute of Medicine , nearly 1 in 5 Medicare beneficiaries live with one or more mental health or substance use conditions . However , fewer than 40 % of these older adults receive treatment .
Chronic Disease Management
Chronic disease is a public health issue affecting 35 % of all Medicare beneficiaries who have at least one chronic condition . Increasing preventive care efforts can help people with chronic conditions better manage
48 THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY