GSK to 'drop patents in poor countries'

GlaxoSmithKline to ‘drop patents in poor countries for better drug access’

  • 31 March 2016
  • From the section Health

GSKImage copyright
Reuters

Pharmaceutical firm GlaxoSmithKline has said it wants to make it easier for manufacturers in the world’s poorest countries to copy its medicines.

The British company said it would not file patents in these countries.

Chief executive Sir Andrew Witty said he wanted to take a “graduated” approach to the company’s “intellectual property” based on the wealth of nations around the globe.

Experts have described the plans as “brave and positive”.

GSK hopes that by removing any fear of it filing for patent protection in poorer countries it will allow independent companies to make and sell versions of its drugs in those areas, thereby widening the public access to them.

‘Clear and simple’

Sir Andrew said he hoped Africa would benefit most from the move.

In accordance with international guidelines set out by the United Nations and World Bank, the company has drawn up a list of 50 countries with a combined population of about 1 billion people, where it has said it will not file for patents.

In what GSK describes as lower middle income countries it will continue to file patents, but will grant licences to generic manufacturers in exchange for a “small royalty”.

Sir Andrew added: “The changes we are setting out aim to make it as clear and simple as possible for generic manufacturers to make and supply versions of GSK medicines.”

The company has said it also wants to put all its future cancer drugs into a Medicines Patent Pool in an effort to address what it described as “the increasing burden of cancer in developing countries”.

The patents pool was established in 2010 and has proved successful in accelerating access to treatments such as HIV, tuberculosis and hepatitis C through voluntary licensing arrangements, which allow generic versions of GSK’s drugs to be made and distributed in poorer countries.

Expanding the pool to include cancer drugs will “add to the wider contribution GSK makes to improve access to effective healthcare around the world”, the company said.

Sir Andrew added: “The experience GSK has with the Medicines Patent Pool for Tivicay – our newest HIV medicine and one of our most commercially successful products – gives us confidence that increasing access, incentivising innovation appropriately and achieving business success can go hand in hand.”

GSK said it would continue to seek full patent protection in richer parts of the world.

‘Broadening access’

Prof Raymond Hill, former President of the British Pharmacological Society, said GSK’s plans set a precedent for other major pharmaceutical companies to follow.

He said: “This is a brave and positive step towards broadening the access to important new medicines in the developing world.

“The impact of this move on the treatment of cancer and other diseases in each individual country will depend on whether there is a local adequate healthcare infrastructure that will allow the safe use of powerful new drugs in an appropriate group of patients.

“Many new cancer drugs are most valuable when used in sub-groups of patients identified by advanced diagnostic techniques that may not be available.”

Prof Alan Boyd, from the Royal Colleges of Physicians, described the plans as “good news” and “significant”

He added: “Access to medicines for patients on a global basis is vital and it is good to see an innovative approach like this to ensure this happens.”

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'Major gaps' in end-of-life care

Around the clock care for dying ‘not good enough’

By Smitha Mundasad
Health reporter
  • 31 March 2016
  • From the section Health

Palliative care - file pictureImage copyright
Amelie-Benoist / BSIP/SPL

A national review of end-of-life care has found most hospitals are failing to provide face-to-face palliative care specialists around the clock.

The review shows only 16 of 142 hospital sites in England offer specialists on site 24/7.

NHS experts acknowledge steady improvements in the last two years, but warn there is still work to do.

It’s the first review since the controversial Liverpool Care Pathway was scrapped.

‘Major deficiencies’

The Liverpool Care Pathway was phased out amid criticisms it had been misused as a tick-box exercise, leaving some patients without food and water.

In its place a series of guidelines has suggested moving away from a one-size-fits-all approach, instead focusing on individual care.

This report, led by the Royal College of Physicians, shows there have been improvements in all areas.

Researchers found, for example, that communication with patients and relatives had improved.

But there were still a number of concerns.

In 18% of more than 9,000 patient notes researchers examined, there was no written evidence to suggest that do-not-resuscitate decisions had been discussed with relatives or friends.

And in around 3,000 notes there was no evidence that the patient’s ability to eat and drink had been assessed on the last day of life.

But the researchers’ main concern was that many patients and doctors did not have full access to on-site palliative care specialists at evenings and weekends.

Out of hours

The majority of hospitals did offer a specialist telephone helpline at all times and 53 of 142 hospital sites offered face-to-face palliative care on Monday to Sunday between 9am to 5pm.

But for 26 trusts there was no record of face-to-face specialist palliative care involving doctors at any time.

Study-lead Dr Sam Ahmedzai said: “We know that most front-line doctors and nurses giving end-of-life care do it to a very good standard.

“But the problem happens when things start to go wrong and often they go wrong out-of-hours in the middle of the night and at weekends.

“Then doctors and nurses who may be inexperienced need to be able to access specialists in palliative care.”

He says without this, patients with complex problems may not get the care they need.


Julie Coombes’ father found out he had bowel cancer in May 2015. He was in and out of hospital for three months. But Ms Coombes, 33, from Plymouth, says her father didn’t feel he had good care there. She says his symptoms and sickness couldn’t be controlled, so the family decided to take him out of hospital to die at home.

She said: “While he was in hospital the palliative care team came for about five minutes, while he was in his bed with everyone around and just said you are going to die.

“Apart from that we did not get any leaflets or any help… It is not something I would want anyone else to experience.”


‘Not right’

Dr Kevin Stewart of the Royal College of Physicians said he was encouraged by the improvements.

But he added: “We are disappointed that there are still major deficiencies in the provision of specialist palliative care at nights and weekends by many trusts; patients and their families deserve the same level of service whatever the day of the week.”

Dr Adrian Tookman, clinical director of the charity Marie Curie, which part-funded the review, said: “We can’t ignore the fact that the vast majority of dying people and those close to them still have limited or no access to specialist palliative care support when they need it in hospital. This is not right, nor good enough.

“Care of the dying has no respect for time, so if we are to deliver a consistent seven-day service by 2020, it is critical that funding is directed towards recruiting and training doctors and nurses to provide specialist care now.”

Dr Tookman told BBC Breakfast there was also “an organisational issue”, over how managers supported services within hospitals.

He acknowledged the difficulties for families of patients but said they had to “speak up and demand the right care”.

Amanda Cheesley of the Royal College of Nursing told BBC Radio 4’s Today programme that end-of-life care raised complex issues and among nurses there was “still a fear of doing the wrong thing”.

NHS England, which commissioned the review, welcomed the improvements, but said it was clear that more could be done.

A spokesperson added: “Although this audit presents a snapshot of end-of-life care within NHS hospitals, there are clear variations in the support and services received – and there are areas where improvements must continue to be made.”

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Collisions with other cyclists are major cause of race injuries

Australia's team race during the 4000m team pursuit qualifying at the 2014 Commonwealth Games in the Chris Hoy velodrome in Glasgow, Scotland, July 24, 2014. REUTERS/Andrew Winning
Australia’s team race during the 4000m team pursuit qualifying at the 2014 Commonwealth Games in the Chris Hoy velodrome in Glasgow, Scotland, July 24, 2014.

Reuters/Andrew Winning


(Reuters Health) – Based on data from northern Belgium, almost one in six non-professional cyclists suffers an accident during a race and colliding with other riders is a major cause.

“Although the number of accidents is quite high, luckily most lesions are minor,” said senior author Dr. Alexander Van Tongel of Ghent University Hospital.

The researchers studied an acute injury registry for the years 2002 and 2012 in Flanders. There were 777 documented reports of accidents with more than 1,000 injuries during non-professional cycling competition.

In 2002, almost 16 percent of registered riders were injured during competition, and 7 percent had more than one accident. About a third of incidents in each year resulted in severe injuries, most commonly injuries of the hand or shoulder.

There were 30 concussions in 2002 and 35 in 2012. In both seasons, colliding with another rider was by far the most frequently reported accident cause, as reported in the British Journal of Sports Medicine.

“What you have to underline is these are competitive injuries,” said Dr. Mark Greve of the Warren Alpert School of Medicine at Brown University in Providence, Rhode Island.

“Cycling events overall have a six times higher rate of injuries than normal bike riding in the community.”

Greve cautioned against applying these results to all types of cycling.

Cycling can be beneficial for obesity, high blood pressure, diabetes and asthma, among other conditions, so the benefits still outweigh the risks, which are relatively small, Greve told Reuters Health.

“As shown in the study, most injuries are caused by collision with other riders,” Van Tongel said by email. “Although the numbers of races in one year are limited for several age groups, currently the number of participants is not limited.”

“The most important risk is head and severe brain injuries,” he said.

The International Cycling Union made hard shell helmets compulsory for races in 2003, and several studies confirm the protective effect of wearing a bicycle helmet for injuries of the head and face, he said.

Shoulder injuries, which are also common, usually heal well with conservative treatment but the competitor will be out of competition for several weeks, Van Tongel said.

“In our opinion, it is very important to wear a hard shell helmet,” he said.

“When evaluating competitive races, our data showed that young riders crashed more because of rider related factors as compared to adult riders,” possibly due to lack of experience, he said. “Smaller pelotons and more training on steering skills instead of speed training may be helpful to reduce the risk during competition.”

SOURCE: bit.ly/22I7uXS British Journal of Sports Medicine, online March 11, 2016.


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Longer night fasting tied to reduced breast cancer recurrence


(Reuters Health) – For breast cancer survivors, the risk of recurrence may be tied to how many hours they fast at night, a new study suggests.

Women in the study were more likely to have their breast cancer come back if they fasted overnight for less than 13 hours, researchers found.

While prolonged fasting is likely harmless, the study’s lead author cautions that more research is needed before women start fasting to prevent their cancer from coming back.

“In science we have a pretty good rule, we don’t go from one study to a public health recommendation,” said Ruth Patterson, of the University of California, San Diego Moores Cancer Center in La Jolla.

Patterson and her colleagues write in JAMA Oncology that while a healthy diet is thought to improve breast cancer outcomes, researchers have mostly focused on what people eat instead of when they eat.

In mice who are fed high-fat diets, long overnight fasting – about 16 hours – has been found to protect against blood sugar problems, inflammation and weight gain. All those conditions are tied to poor cancer outcomes, the authors note.

To see if the length of overnight fasting is linked with breast cancer recurrence or death, the researchers tracked 2,413 participants in the Women’s Health Eating and Living study.

None of the women had diabetes, but they had all been diagnosed with breast cancer between ages 24 and 70.

During roughly seven years of follow-up, 390 of the women developed a recurrence of their breast cancer.

Overall, 818 women reported fasting overnight for at least 13 hours. The other 1,595 fasted for shorter periods at night – and this group had a 36 percent greater risk of breast cancer recurrence, compared to women who held off on eating for at least 13 hours a night.

There was also some evidence that women who fasted for shorter periods at night were more likely to die from breast cancer or any cause, but those findings may have been due to chance.

The new study can’t say why overnight fasts might influence breast cancer risk, but the researchers found that with every additional two hours of fasting, women’s average blood sugar went down and their hours of sleep were increased.

“Maybe sleep and insulin levels may be affecting downstream risks including breast cancer,” Patterson told Reuters Health.

There is great appeal in finding something people can change about their diets that would ultimately impact their cancer risk, said Dr. Jeffrey Peppercorn, a breast cancer expert at Massachusetts General Hospital in Boston.

However, “I don’t think this study alone should change how we council women tomorrow,” said Peppercorn, who was not involved in the new study.

For example, he noted, the new study is limited by the use of food questionnaires that were only collected at three points in time, and the participants’ diets may not have been consistent throughout the study.

“There is no harm in this that I know of, but before you make a public health recommendation, you want to know it’s valid and that thing you’re suggesting they do is actually causing the benefits you see,” he told Reuters Health.

Patterson agreed that more evidence is needed.

“I would say there is no harm in trying it in terms of seeing if you sleep better and feel better in terms of metabolic health, but I don’t think I’d say it will help with your breast cancer recurrence risk,” she said.

SOURCE: bit.ly/1Y241jz JAMA Oncology, online March 31, 2016.


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The Marketplace Risk Adjustment Program: Promoting Access, Quality, and Choice for Consumers

The Marketplace Risk Adjustment Program: Promoting Access, Quality, and Choice for Consumers

March 30

By Kevin Counihan, CEO of the Health Insurance Marketplaces
Dr. Patrick Conway, CMS Acting Principal Deputy Administrator

This week, CMS brings together health care stakeholders and experts to discuss an esoteric sounding, yet important, topic: the individual and small group market risk adjustment programs created by the Affordable Care Act (ACA).  Risk adjustment is critical to making the ACA’s better-known market reforms work well for insurers and consumers. By reducing incentives for issuers to try to design products that attract a healthy risk pool, risk adjustment lets issuers compete on quality, price, and products that meet the needs of all consumers, protecting consumers’ access to a range of robust options.

Risk adjustment is a longstanding and important part of the Medicare Advantage and Medicare Prescription Drug Programs and has proven effective in making these programs work well for seniors.  Likewise, the ACA’s risk adjustment program is already delivering on its promise of affordable coverage that meets consumers’ needs. But, there is always room for improvement.

That’s why CMS recently released a white paper (https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/RA-March-31-White-Paper-032416.pdf) that evaluates our experience with the risk adjustment formula to date and analyzes possible changes. The white paper provides data and analysis about how the program has operated in the past, so that information, best practices, and ideas for improvement can be shared. And that’s why we’re bringing a broad range of stakeholders together to discuss these issues.

As we consider comments and feedback in our meeting on Thursday, March 31, on the future of the ACA’s risk adjustment program, we will keep in mind key principles to simultaneously make improvements while staying true to the goals of the program.

Promoting Access, Quality, and Choice for Consumers with Diverse Health Care Needs

Before the ACA, Americans with pre-existing medical conditions were often left out of the health insurance market. Now, because of the ACA, Americans with pre-existing condition can no longer be charged more or denied coverage just because they’ve been sick.

This means that insurance companies have had to adapt to a new way of working.  Instead of “medical underwriting” – a practice where an insurance company requires you to disclose your health status to determine whether to offer you coverage, at what price, and with what exclusions – insurance companies must offer you coverage regardless of your health status and can’t charge you more for being sick.

Risk adjustment is an essential part of making the individual and small group markets work well under a system where everyone, including people with pre-existing conditions, can buy high-quality coverage.

Through risk adjustment, insurance companies with sicker-than-average enrollees receive payments from other health insurance companies with healthier-than-average enrollees. That means that issuers make or lose money based on the characteristics of the products they offer, rather than how sick or healthy their enrollees are. This, in turn, lets issuers compete in the market by designing products that meet the needs of all consumers, rather than designing products to be unattractive to those who are sick.

For example, thanks to risk adjustment, it can make financial sense for issuers to develop specialized care management programs to meet the needs of people with chronic or other conditions. If such plans attract more expensive enrollees, issuers know they will be compensated by risk adjustment.

We are already seeing some Marketplace plans innovate in this area to meet the needs of consumers with challenging health issues, for example by offering plans that focus on diabetes management and other chronic illnesses. Risk adjustment may also help new or smaller businesses participate in the market without fear of attracting a large number of sick enrollees in any particular year.

Assessing the Marketplace Risk Adjustment Program

The risk adjustment methodology was designed with input from trade associations, insurance companies, actuaries, clinicians, economists, and other members of the public. It was implemented through rulemaking with a public notice and comment period. CMS worked closely with health insurance companies to ensure that the risk adjustment program uses the best available data. And all insurance companies – large and small, new or established – play by the same rules.

The first finding of the CMS white paper is that the risk adjustment program has largely worked as intended to date. For the 2014 benefit year, the formula successfully transferred $4.6 billion from issuers with healthier enrollees to issuers with sicker enrollees.  Our data and an outside independent analysis (http://health.oliverwyman.com/maximize-value/2016/02/a_story_in_four_char.html) found that the main determinant of whether an issuer received a payment is the relative health of their enrollees, which is a sign of health for the program.

These analyses also show that the formula hasn’t favored large plans over small plans, or the reverse, indicating no bias by the size of the plan or insurance company. We expect performance of the program to improve with experience. Accurate risk adjustment payments depend on issuers accurately collecting, managing, and submitting data on their population’s health. While the ACA-compliant individual and small group markets are still relatively new, these core capabilities appear to have worked well in 2014 and we expect will contribute to successful health plan operation even in a market without risk adjustment.

What’s Next?

We have recently made and announced a number of changes to risk adjustment. In response to issuers’ requests for earlier information, we distributed risk adjustment data reports to insurance companies earlier this month to help them with setting their 2017 rates. These early reports rely on the information insurance companies report to CMS, and so they are only available in markets where sufficient issuers had submitted their data, and they are only as accurate as the data provided. This is why it is important that the companies focus on data management to fully and accurately report their experience and try to do so as early in the year as feasible.

We have also made some other adjustments to the methodology for the 2017 plan year including using more recent data, updating medical and drug trends, and incorporating preventive services into companies’ risk adjustment calculations.

As we contemplate making additional changes, we want to get more input from the public. And that’s the purpose of the public meeting on risk adjustment. As outlined in more detail in the white paper, some of the ideas we want to discuss include: whether and how to account for partial year enrollment in the model; whether and how to develop a prescription drug model, accounting for newer high-cost medications; whether and how to pool high risk enrollees; and whether and how to recalibrate the model based on data for the individual and small group populations, instead of a commercial dataset drawn from the employer market.

We look forwarding to hearing feedback from the public about these and other possible changes to the risk adjustment program.

We will continue to listen and learn to make sure we operate this vital program to maximum effect. We will take feedback and suggestions through April 22, 2016, and will keep the public informed as we consider proposals to change and improve the risk adjustment program in 2018 to serve the goals of providing affordable coverage and better care for millions of Americans.

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The Marketplace Risk Adjustment Program: Promoting Access, Quality, and Choice for Consumers

The Marketplace Risk Adjustment Program: Promoting Access, Quality, and Choice for Consumers

March 30

By Kevin Counihan, CEO of the Health Insurance Marketplaces
Dr. Patrick Conway, CMS Acting Principal Deputy Administrator

This week, CMS brings together health care stakeholders and experts to discuss an esoteric sounding, yet important, topic: the individual and small group market risk adjustment programs created by the Affordable Care Act (ACA).  Risk adjustment is critical to making the ACA’s better-known market reforms work well for insurers and consumers. By reducing incentives for issuers to try to design products that attract a healthy risk pool, risk adjustment lets issuers compete on quality, price, and products that meet the needs of all consumers, protecting consumers’ access to a range of robust options.

Risk adjustment is a longstanding and important part of the Medicare Advantage and Medicare Prescription Drug Programs and has proven effective in making these programs work well for seniors.  Likewise, the ACA’s risk adjustment program is already delivering on its promise of affordable coverage that meets consumers’ needs. But, there is always room for improvement.

That’s why CMS recently released a white paper (https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/RA-March-31-White-Paper-032416.pdf) that evaluates our experience with the risk adjustment formula to date and analyzes possible changes. The white paper provides data and analysis about how the program has operated in the past, so that information, best practices, and ideas for improvement can be shared. And that’s why we’re bringing a broad range of stakeholders together to discuss these issues.

As we consider comments and feedback in our meeting on Thursday, March 31, on the future of the ACA’s risk adjustment program, we will keep in mind key principles to simultaneously make improvements while staying true to the goals of the program.

Promoting Access, Quality, and Choice for Consumers with Diverse Health Care Needs

Before the ACA, Americans with pre-existing medical conditions were often left out of the health insurance market. Now, because of the ACA, Americans with pre-existing condition can no longer be charged more or denied coverage just because they’ve been sick.

This means that insurance companies have had to adapt to a new way of working.  Instead of “medical underwriting” – a practice where an insurance company requires you to disclose your health status to determine whether to offer you coverage, at what price, and with what exclusions – insurance companies must offer you coverage regardless of your health status and can’t charge you more for being sick.

Risk adjustment is an essential part of making the individual and small group markets work well under a system where everyone, including people with pre-existing conditions, can buy high-quality coverage.

Through risk adjustment, insurance companies with sicker-than-average enrollees receive payments from other health insurance companies with healthier-than-average enrollees. That means that issuers make or lose money based on the characteristics of the products they offer, rather than how sick or healthy their enrollees are. This, in turn, lets issuers compete in the market by designing products that meet the needs of all consumers, rather than designing products to be unattractive to those who are sick.

For example, thanks to risk adjustment, it can make financial sense for issuers to develop specialized care management programs to meet the needs of people with chronic or other conditions. If such plans attract more expensive enrollees, issuers know they will be compensated by risk adjustment.

We are already seeing some Marketplace plans innovate in this area to meet the needs of consumers with challenging health issues, for example by offering plans that focus on diabetes management and other chronic illnesses. Risk adjustment may also help new or smaller businesses participate in the market without fear of attracting a large number of sick enrollees in any particular year.

Assessing the Marketplace Risk Adjustment Program

The risk adjustment methodology was designed with input from trade associations, insurance companies, actuaries, clinicians, economists, and other members of the public. It was implemented through rulemaking with a public notice and comment period. CMS worked closely with health insurance companies to ensure that the risk adjustment program uses the best available data. And all insurance companies – large and small, new or established – play by the same rules.

The first finding of the CMS white paper is that the risk adjustment program has largely worked as intended to date. For the 2014 benefit year, the formula successfully transferred $4.6 billion from issuers with healthier enrollees to issuers with sicker enrollees.  Our data and an outside independent analysis (http://health.oliverwyman.com/maximize-value/2016/02/a_story_in_four_char.html) found that the main determinant of whether an issuer received a payment is the relative health of their enrollees, which is a sign of health for the program.

These analyses also show that the formula hasn’t favored large plans over small plans, or the reverse, indicating no bias by the size of the plan or insurance company. We expect performance of the program to improve with experience. Accurate risk adjustment payments depend on issuers accurately collecting, managing, and submitting data on their population’s health. While the ACA-compliant individual and small group markets are still relatively new, these core capabilities appear to have worked well in 2014 and we expect will contribute to successful health plan operation even in a market without risk adjustment.

What’s Next?

We have recently made and announced a number of changes to risk adjustment. In response to issuers’ requests for earlier information, we distributed risk adjustment data reports to insurance companies earlier this month to help them with setting their 2017 rates. These early reports rely on the information insurance companies report to CMS, and so they are only available in markets where sufficient issuers had submitted their data, and they are only as accurate as the data provided. This is why it is important that the companies focus on data management to fully and accurately report their experience and try to do so as early in the year as feasible.

We have also made some other adjustments to the methodology for the 2017 plan year including using more recent data, updating medical and drug trends, and incorporating preventive services into companies’ risk adjustment calculations.

As we contemplate making additional changes, we want to get more input from the public. And that’s the purpose of the public meeting on risk adjustment. As outlined in more detail in the white paper, some of the ideas we want to discuss include: whether and how to account for partial year enrollment in the model; whether and how to develop a prescription drug model, accounting for newer high-cost medications; whether and how to pool high risk enrollees; and whether and how to recalibrate the model based on data for the individual and small group populations, instead of a commercial dataset drawn from the employer market.

We look forwarding to hearing feedback from the public about these and other possible changes to the risk adjustment program.

We will continue to listen and learn to make sure we operate this vital program to maximum effect. We will take feedback and suggestions through April 22, 2016, and will keep the public informed as we consider proposals to change and improve the risk adjustment program in 2018 to serve the goals of providing affordable coverage and better care for millions of Americans.

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CMS Invites Quality Innovation Network-Quality Improvement Organizations to Submit Special Innovation Projects to Expand Their Reach in Improving Care Delivery

CMS Invites Quality Innovation Network-Quality Improvement Organizations to Submit Special Innovation Projects to Expand Their Reach in Improving Care Delivery

March 30

By: Patrick Conway, MD, MSc
Acting Principal Deputy Administrator
Deputy Administrator for Innovation and Quality
CMS Chief Medical Officer

Kate Goodrich, MD MHS
Director
Center for Clinical Standards and Quality

Jean Moody-Williams, RN, MPP
Deputy Director
Center for Clinical Standards and Quality

Dennis Wagner, MPA
Director, Quality Improvement and Innovation Group
Center for Clinical Standards and Quality

The Centers for Medicare & Medicaid Services’ (CMS) Quality Improvement Organization (QIO) Program is constantly evolving to help ensure that Medicare beneficiaries receive better care, better health, and greater value. Today, CMS is announcing the program’s next evolution: two projects focused on supporting and scaling quality improvement innovations.

With this announcement, Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) can collaborate with health care providers and/or partners to compete for 28 Special Innovation Project (SIP) awards that fall within two topic categories totaling $8 million.

SIPs are two-year quality improvement projects that align with the goals of the CMS Quality Strategy (https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/CMS-Quality-Strategy.html) and emphasize the power of partnerships. There are two categories of SIPs for QIN-QIOs to consider:

  1. “Innovations that Advance Local Efforts for Better Care and Smarter Spending,” which will address healthcare quality issues that occur within specific QIN-QIO regions.
  1. “Interventions that are Ripe for Spread and Scalability,” which will focus on expanding the scope and national impact of a quality improvement project that has experienced proven but limited success. The expectation is that similar benefits would be experienced on a large scale if spread throughout the greater health care community.

The scalability category aligns with the CMS Strategic Innovation Engine (SIE) (http://sie.qioprogram.org/), a new endeavor launched in August of 2015. The SIE is working to rapidly move innovative, evidence-based quality practices from research to implementation through the QIO Program. In consultation with the SIE Executive Leadership Council, CMS is seeking projects that:

  • Streamline patient flow in various health care settings, including hospital units, outpatient clinics, primary care offices, ambulatory surgical centers, and cancer centers resulting in efficiencies, improved satisfaction, decreased mortality, better care, healthier people, and smarter spending.
  • Work with health plans and/or care coordination providers to deploy an integrated approach to post-acute care that results in enhanced care management, safe transitions from one care setting to another, improved health outcomes, and reductions in harms.
  • Increase value, patient affordability, and appropriate use of specialty drugs by applying evidenced based criteria to prescribing practices and by monitoring effectiveness when providers have a choice(s) among equally effective drugs with differing costs.
  • Address acute pain management. For example, more is needed to assist sickle cell patients: from accurate identification of their illness to education of emergency department staff on sickle cell disease while addressing the cultural stigmas often associated with the disease.
  • Utilize big data analytics to reduce preventable harm in healthcare.

We encourage those in the larger healthcare community who are leading quality work in these areas, with interventions and proven results, to reach out and explore potential partnerships with QIN-QIOs. Through collaboration with healthcare providers, patients, families, and other key stakeholders, QIN-QIOs have tremendous potential to take those interventions to the national level and improve the health care delivery system by tapping into new settings of care and building upon the knowledge gained by people working on the front line of providing quality health care.

The QIN-QIOs selected to carry out these SIPs will leverage their data-driven approach, extensive partnerships, and the voices of patients and families to positively impact Medicare beneficiaries in their communities and nationwide.

The QIO Program’s 14 QIN-QIOs work with providers, community partners and beneficiaries on multiple data-driven quality improvement initiatives to improve patient safety, reduce harm, engage patients and families, improve clinical care and reduce healthcare disparities. For more information about the CMS QIO Program and for a complete list of QIN-QIOs, please visit the QIO Program website (http://www.qioprogram.org/).

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CMS Invites Quality Innovation Network-Quality Improvement Organizations to Submit Special Innovation Projects to Expand Their Reach in Improving Care Delivery

CMS Invites Quality Innovation Network-Quality Improvement Organizations to Submit Special Innovation Projects to Expand Their Reach in Improving Care Delivery

March 30

By: Patrick Conway, MD, MSc
Acting Principal Deputy Administrator
Deputy Administrator for Innovation and Quality
CMS Chief Medical Officer

Kate Goodrich, MD MHS
Director
Center for Clinical Standards and Quality

Jean Moody-Williams, RN, MPP
Deputy Director
Center for Clinical Standards and Quality

Dennis Wagner, MPA
Director, Quality Improvement and Innovation Group
Center for Clinical Standards and Quality

The Centers for Medicare & Medicaid Services’ (CMS) Quality Improvement Organization (QIO) Program is constantly evolving to help ensure that Medicare beneficiaries receive better care, better health, and greater value. Today, CMS is announcing the program’s next evolution: two projects focused on supporting and scaling quality improvement innovations.

With this announcement, Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) can collaborate with health care providers and/or partners to compete for 28 Special Innovation Project (SIP) awards that fall within two topic categories totaling $8 million.

SIPs are two-year quality improvement projects that align with the goals of the CMS Quality Strategy (https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/CMS-Quality-Strategy.html) and emphasize the power of partnerships. There are two categories of SIPs for QIN-QIOs to consider:

  1. “Innovations that Advance Local Efforts for Better Care and Smarter Spending,” which will address healthcare quality issues that occur within specific QIN-QIO regions.
  1. “Interventions that are Ripe for Spread and Scalability,” which will focus on expanding the scope and national impact of a quality improvement project that has experienced proven but limited success. The expectation is that similar benefits would be experienced on a large scale if spread throughout the greater health care community.

The scalability category aligns with the CMS Strategic Innovation Engine (SIE) (http://sie.qioprogram.org/), a new endeavor launched in August of 2015. The SIE is working to rapidly move innovative, evidence-based quality practices from research to implementation through the QIO Program. In consultation with the SIE Executive Leadership Council, CMS is seeking projects that:

  • Streamline patient flow in various health care settings, including hospital units, outpatient clinics, primary care offices, ambulatory surgical centers, and cancer centers resulting in efficiencies, improved satisfaction, decreased mortality, better care, healthier people, and smarter spending.
  • Work with health plans and/or care coordination providers to deploy an integrated approach to post-acute care that results in enhanced care management, safe transitions from one care setting to another, improved health outcomes, and reductions in harms.
  • Increase value, patient affordability, and appropriate use of specialty drugs by applying evidenced based criteria to prescribing practices and by monitoring effectiveness when providers have a choice(s) among equally effective drugs with differing costs.
  • Address acute pain management. For example, more is needed to assist sickle cell patients: from accurate identification of their illness to education of emergency department staff on sickle cell disease while addressing the cultural stigmas often associated with the disease.
  • Utilize big data analytics to reduce preventable harm in healthcare.

We encourage those in the larger healthcare community who are leading quality work in these areas, with interventions and proven results, to reach out and explore potential partnerships with QIN-QIOs. Through collaboration with healthcare providers, patients, families, and other key stakeholders, QIN-QIOs have tremendous potential to take those interventions to the national level and improve the health care delivery system by tapping into new settings of care and building upon the knowledge gained by people working on the front line of providing quality health care.

The QIN-QIOs selected to carry out these SIPs will leverage their data-driven approach, extensive partnerships, and the voices of patients and families to positively impact Medicare beneficiaries in their communities and nationwide.

The QIO Program’s 14 QIN-QIOs work with providers, community partners and beneficiaries on multiple data-driven quality improvement initiatives to improve patient safety, reduce harm, engage patients and families, improve clinical care and reduce healthcare disparities. For more information about the CMS QIO Program and for a complete list of QIN-QIOs, please visit the QIO Program website (http://www.qioprogram.org/).

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