Medicare Beneficiary Quality Improvement Program (MBQIP)
The MBQIP for Critical Access Hospitals (CAHs) is a quality improvement activity under the Medicare Rural Hospital Flexibility (Flex) Program of the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP). MCRH facilitates this program for the State of MI.
- The goal of MBQIP is to improve the quality of care provided in CAHs, by increasing quality data reporting by CAHs and then driving quality improvement activities based on the data. This project provides an opportunity for individual hospitals to look at their own data, measure their outcomes against other CAHs, and partner with other hospitals in the state around quality improvement initiatives to improve outcomes and provide the highest quality care to each and every one of their patients.
All MI CAHs participate in the MBQIP program. MBQIP's Core Improvement Initiatives fall under four domains:
- Patient Safety
- Patient Engagement
- Care Transitions
- Outpatient
Additional domains are recommended but not required. Details on the current domains are available here.
MICAH QN and MBQIP Alignment
The MICAH QN supports and recommends full participation in the MBQIP program. As part of this support, the MBQIP data is reported out at the MICAH QN quarterly meetings and Strategy Group #2 provides peer sharing and best practices around the data.
Why should CAHs participate in the MBQIP program?
- CAHs are affected directly and indirectly by the rapidly changing health care payment and delivery environment.
- This includes an increased focus on moving beyond models that have financial incentives for quality and value, to models that include a component of downside financial risk. CMS has outlined a goal to have 50 percent of traditional Medicare and Medicare Advantage payments in models with downside risk by 2022, and 100 percent by 2025. Medicaid and other payers are expected to follow in this direction as well.
- Although CMS does not currently mandate quality reporting by CAHs, it cannot be considered optional for CAHs to keep pace in an environment that has rapidly shifted to focus on value
- Although the Centers for Medicare & Medicaid Services (CMS) has not mandated CAH quality reporting, other programs are driving measurement and reporting.
- In September 2019, CMS published a final rule that included updates to the CAH Conditions of Participation. One aspect of the proposed rule refines the language related to the implementation of a Quality Assessment and Performance Improvement (QAPI) program. In the final rule, CMS actively encourages CAHs to “utilize the technical assistance and services for CAHS that are available
- through the State Flex Programs, including MBQIP.”
- CAHs are increasingly in the spotlight of federal policymakers, and there is recognition that quality measurement is necessary, but can be challenging in a rural environment.
Alignment with the MI Medicare Rural Hospital Flexibility Grant Program
The MI Flex Program provides a wide variety of resources to MI CAHs including but not limited to the following:
- Swing Bed Quality and Utilization Technical Assistance
- Lean and Service Line Projects/Assessments
- Financial Benchmarking
- Quality Benchmarking
- Quality Improvement Training via the Institute for Healthcare Improvement
- Mileage and Lodging support for CAH-specific meetings
- Board of Directors Training
- Population Health Resources
In 2019, HRSA developed a phased approach in which thresholds of MBQIP participation would allow for CAHs to be eligible for Flex Funded resources, such as those described above. To learn more about this, please reach out to Crystal Barter.
MBQIP Quality Measure Resources
2024 MBQIP Open Office
March - MBQIP Q&A
January - The Future of MBQIP - Are You Ready?