AQAF, Alabama’s Medicare Quality Improvement Organization
Cullman Long Term Care and Rehabilitation, and Woodland Village Health Care Center are two of 23 Alabama nursing homes participating in the “Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents.” The initiative, funded by the Centers for Medicare & Medicaid Services, is being led in Alabama by AQAF, Alabama’s Medicare Quality Improvement Organization (QIO).
Nearly two-thirds of nursing facility residents are enrolled in Medicaid, and most are also enrolled in Medicare. These Medicare-Medicaid dual enrollees are among the most fragile and chronically ill individuals served by the programs. Research found that approximately 45 percent of hospitalizations among Medicare-Medicaid enrollees receiving either Medicare skilled nursing facility services or Medicaid nursing facility services could have been avoided. Total costs for these potentially avoidable hospitalizations for Medicare-Medicaid enrollees for 2011 were estimated to be between $7 and 8 billion.
AQAF has an on-site registered nurse, called a care pathways coach, to partner with the existing nursing facility staff to provide preventive services as well as to improve assessments and management of medical conditions. AQAF is also working toward more seamless nursing home resident transitions of care, among many other activities. The work will be subject to a rigorous external evaluation.
AQAF is working with Cullman Long Term Care, Woodland Village and 21 other nursing homes in 14 counties in central and north central Alabama. Partnering with AQAF on the initiative are the Alabama Department of Senior Services, the Alabama Department of Public Health, the Alabama Medicaid Agency, the University of Alabama Center for Mental Health and Aging, the University of Alabama at Birmingham’s Department of Gerontology and Palliative Medicine, Samford University’s McWhorter School of Pharmacy, the Alabama Nursing Home Association, the Alabama Hospital Association, and the Alabama Medical Directors Association.
Birmingham-based AQAF provides health care quality improvement services to clients in the public and private sectors. AQAF serves as Alabama’s Medicare Quality Improvement Organization. For more information visit www.aqaf.com.