Herding Cats Made Easier: A Model for Supporting Consistent Local Communications about a Federal Health Quality Program

Background: The Centers for Medicare & Medicaid Services’ (CMS) Quality Improvement Organization (QIO) Program spans 41 contractor organizations in 53 jurisdictions. Contractors, known as QIOs, engage health care providers, Medicare beneficiaries and other health quality stakeholders at the community level in national improvement initiatives to achieve CMS’ three-part aim: better care, better health for people and communities, and affordable care through lowering costs by improvement. QIOs are the face of the QIO Program to most beneficiaries and front-line providers. Their strong local knowledge and relationships make them an effective channel through which CMS can activate millions of health quality stakeholders to achieve national goals that include reducing the incidence of health-care acquired conditions, coordinating care transitions and increasing the utilization of preventive services.

Program background: CMS designates a small number of QIOs with subject matter expertise as QIO Support Centers (QIOSCs) to provide technical assistance to other QIOs and assist CMS in developing QIO Program resources. The Communications QIOSC facilitates strategic communications by QIOs that advance progress toward the program’s goals. Every six months, the QIOSC develops a national QIO Program communications plan that guides its work and serves as a model for semi-annual QIO communications plans. Each QIO has a single point of contact at the QIOSC, an account manager, who provides feedback on the QIO’s communications plan and offers consultation on communications strategy and activities. The QIOSC also produces resources for consistent communication that include a toolkit for developing success stories, key messages for communicating about program challenges and changes, ongoing identification and rapid sharing of best practices, and training in such topics as social marketing and evaluation.  

Evaluation Methods and Results: A semi-annual QIO communications needs assessment allows CMS and the QIOSC to identify priorities for training and resource development. Quarterly surveys of QIO satisfaction with the QIOSC’s services over an 18-month period found high rates of use or planned use (> 90%) for most communications resources and an overall level of satisfaction above 95%.  Based on qualitative review of QIO communications plans, there appears to be an increase during the term of the QIOSC’s operations in most QIOs’ ability to develop, execute and evaluate communications programs that contribute to measurable improvements in health quality.  

Conclusions: The QIOSC model for centralized communications support is an effective solution for bringing the communications of local contractors or grantees into alignment with national program communications. By supporting consistent messaging, this model also prepares local components to adopt a national program brand. Optimizing the local channel allows federal agencies to increase the reach of their communications while operating within budget constraints.

Implications for research and/or practice: The synergy created by coordinated national and local communications contributes to the attainment of federal health care objectives.  It also has the potential to dramatically increase the quality and quantity of public engagement in national health initiatives. This material was prepared by VHQC, the QIO Support Center for Communications, under contract with the Centers for Medicare & Medicaid Services, an agency of the Department of Health and Human Services. VHQC/CommQIOSC/3/31/2011/1084