The AHCA Quality Initiative 2018-2021

The AHCA Quality Initiative is a national, multi-year effort to further improve quality of care in America’s long term and post-acute care centers. Since the launch of the Initiative in 2012, members have been challenged to meet measurable targets in key areas such as hospitalizations and antipsychotics usage. While significant improvements have been made, more must be done. The next phase of the effort continues to challenge providers to achieve quantitative results in four areas by March 2021. These areas are top priorities for the Centers for Medicare & Medicaid Services (CMS), Accountable Care Organizations (ACOs) as well as Managed Care Organizations (MCOs), and are aligned with federal mandates that link financial outcomes to quality performance.

  • The Quality Initiative Fact Sheet

    Contains 2 Component(s)

    The American Health Care Association (AHCA) has broadened its Quality Initiative* to further improve the quality of care in America’s skilled nursing care centers. The expansion of the Initiative will challenge members to apply the Baldrige Excellence Framework to meet measurable targets in eight critical areas by March 2018. These areas are aligned with the Centers for Medicare & Medicaid Services (CMS)’ Quality Assurance/Performance Improvement (QAPI) program and federal mandates, such as Five-Star and the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.

    The American Health Care Association (AHCA) has broadened its Quality Initiative* to further improve the quality of care in America’s skilled nursing care centers. The expansion of the Initiative will challenge members to apply the Baldrige Excellence Framework to meet measurable targets in eight critical areas by March 2018. These areas are aligned with the Centers for Medicare & Medicaid Services (CMS)’ Quality Assurance/Performance Improvement (QAPI) program and federal mandates, such as Five-Star and the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.

  • Hospitalizations

    Contains 5 Component(s) Recorded On: 05/07/2014

    Safely reduce long-stay and short- stay hospitalizations by improving 10% (Q1 2017 baseline rates)- or maintain a rate of 10% or less- by March 2021.

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    Hospital readmissions not only have the potential for negative physical, emotional, and psychological impacts on individuals in skilled nursing care, but also cost the Medicare program billions of dollars. 

    Preventing these events whenever possible is always beneficial to residents and has been identified by policymakers and providers as an opportunity to reduce overall health care system costs through improvements in quality. The issue is a top priority for the Centers for Medicare & Medicaid Services (CMS) and managed care programs. An example of this is the Skilled Nursing Facility (SNF) Value Based Purchasing (VBP) Program, a CMS effort that links financial outcomes to quality performance that starts on October 1, 2018. 

  • Customer Satisfaction

    Contains 4 Component(s) Recorded On: 04/11/2012

    Improve long- stay and short- stay satisfaction by 10% (Q1 2017 baseline rates) - or achieve a rate of > 90%- by March 2021.

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    Similar to many other professions, the happiness and peace of mind of residents and their families is paramount to skilled nursing care centers. That is why the Association has made great progress in identifying a customer satisfaction survey—CoreQ—that can be uniformly used by long term and post-acute care providers.

  • Functional Outcomes

    Contains 1 Component(s) Recorded On: 09/11/2014

    Improve functional outcomes (self- care and mobility) by 15% (Q1 2017 baseline rates) by March 2021.

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    Skilled nursing care providers improve the lives of the residents they care for in a number of ways, including improving their functional outcomes and independence. 

    The Medicare Payment Advisory Commission (MedPAC), the IMPACT Act, and CMS all called for the development of functional improvement measures based on the self-care and mobility sections of the Continuity Assessment Record and Evaluation (CARE) tool.Maintaining or improving mobility and self-care abilities is important to healthy aging and maximizing independence.

  • Reducing Unnecessary Use of Antipsychotic Medication

    Contains 7 Component(s) Recorded On: 10/27/2014

    Safely reduce the off-label use of antipsychotics by 10% (Q1 2017 baseline rates)- or maintain a rate of 8% or less in long- stay residents, and maintain a rate of 1% or less in short- stay residents- by March 2021.

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    A large number of the individuals in skilled nursing centers are living with some type of dementia. For these individuals and as illness progresses, behavior often becomes a key form of communication. This can be challenging for families and staff, and too often, antipsychotic medication is used in an attempt to modify behavior. The use of antipsychotic medication to treat behavior associated with dementia is not supported clinically and is considered off-label by the FDA, which issued a “black box” warning for the elderly with dementia.

    Antipsychotic drugs are expensive, costing hundreds of millions of Medicare dollars. They also increase the risk of death, falls with fractures, hospitalizations and other complications resulting in poor health and high costs.

    The intent of the AHCA Quality Initiative goal to safely reduce the off-label use of antipsychotics is to encourage alternative strategies for responding to challenging behavioral expressions in persons living with dementia before considering medications and to ensure that antipsychotic medications, when used, are as appropriate and safe as possible.

    Building Prevention into Every Day Practice: A Framework for Successful Clinical Outcomes is a framework designed by the Association’s Clinical Practice Committee that outlines guiding elements such as individualized care approaches, effective transitions of care, QAPI concepts, safety, risk management, team-based care, and diagnostic quality.  Care providers that use these resources can more effectively apply knowledge through organizational approaches and clinical care that leads to optimal patient outcomes and quality of life. Click here to register for this (free) resource. 

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