OUR TA

We use key informant interviews to understand a client’s organization, culture, and definition of success. Using a validated readiness assessment, we work collaboratively to identify strengths and weaknesses and potential gaps in care. In addition to our experience in helping hundreds of practices meet their goals, we offer time-tested tools and approaches to ensure success. We combine adult learning best practices with change management techniques to create “just-in-time” learning opportunities, as well as peer-to-peer communication and sharing designed to make change stick. We also provide access to established online learning modules that are available anytime, which allows flexibility and reduces practice burden and fatigue. We recognize that no two engagements are the same and customize each approach based on the client’s needs so that you achieve your definition of success.

WHAT MAKES THIS VENDOR UNIQUE

  • For over 35 years, our focus has remained centered on the implementation of healthcare quality improvement best practices across New England, with recognized successes as a trusted QIN-QIO and Practice Transformation Network (PTN) leading to a prime position on CMS’s Network of Quality Improvement and Innovation Contractors (NQIIC) vehicle.
  • We are a recognized leader across the region in provider focused learning and diffusion, including serving as a lead Project ECHO® Replication Hub across New England, and offer an extensive array of synchronous and asynchronous educational programs, with significant focus on addressing the opioid epidemic.
  • We have created community-based programs that have avoided over $200 million of costs associated with inappropriate admissions, readmissions, and ED visits.
  • For the last 17 years, we have performed the analysis for the Agency for Healthcare Research and Quality’s Medicare Patient Safety Monitoring System.
  • Extensive history of clinician quality improvement and support through CMMI’s Practice Transformation Network and State Innovation Model work across New England. Qualidigm has developed comprehensive playbooks that support integrated best practices in working with advanced care networks, accountable care organizations (ACOs) and community partners (CPs) for behavioral health integration, health equity, and long-term services and support.

A SUCCESSFUL TA EXPERIENCE

We provided TA to a large Advanced Network ACO consisting of six hospitals and several primary care and specialty physician offices throughout Connecticut. The ACO had earned Patient Centered Medical Home (PCMH) recognition in previous years and was considering completing the recognition process again. As part of a change management process that attempts to create a sense of urgency and help the ACO answer the question “Why do we need to do this?”, Qualidigm performed an assessment to identify potential barriers and opportunities for improvement. Qualidigm educated leadership, providers, and finance personnel at the ACO on the benefits of PCMH recognition, and how PCMH aligns with and supports their current ACO contracts. They also educate clinicians about PCMH+, a program sponsored by the CT Medicaid Department, MIPS, and other quality improvement and reporting initiatives. Qualidigm worked with the ACO to create an individualized project plan, augmented its webinar-based TA with in-person group meetings, and developed a detailed checklist of PCMH requirements based on the ACO’s PCMH pre-validated EHR. Ultimately, the ACO received PCMH Level 3 recognition for all 26 primary care physician offices that submitted to National Committee for Quality Assurance.

OTHER DETAILS

In 2019, we merged with Maine Quality Counts, the Northern New England Practice Transformation Network, recognized by CMS for “excellence Patient and Family Engagement.” Since this merger, we have become a leader in provider-based education to address the opioid epidemic in Maine.

The statements in this document are made solely by Qualidigm. No statement in this document should be construed as an official position of or endorsement by Abt Associates Inc. or the Massachusetts Executive Office of Health and Human Services.

ABOUT QUALIDIGM

Qualidigm is a mission-driven healthcare consulting organization that provides innovative and scientifically-based solutions to transform care and improve care delivery and patient outcomes by improving the quality, safety, and cost-effectiveness of healthcare through transformational change. Qualidigm is recognized among the healthcare provider network as a facilitator and leader in performing peer-reviewed research, providing evidence-based education, and implementing learning sessions that foster collaboration and accelerate change. Staff has expertise in clinical medicine, quality improvement, project management, patient safety, public health, patient-centered medical home, care coordination, utilization review, data evaluation and analysis and patient/provider education.

Qualidigm looks forward to working with ACOs and CPs to help achieve transformational change – working collaboratively to integrate care coordination across the healthcare continuum, coordinate care with behavioral health and dental providers, provide comprehensive medication management, promote health equity, expand patient engagement, and align priorities within the MassHealth program.

ORGANIZATION FUN FACTS

  • In 2018, Qualidigm merged with Maine Quality Counts, the 2018 Northern New England PTN recognized by CMS for “excellence Patient and Family Engagement.”
  • In a speech marking the 5th anniversary of the Affordable Care Act, President Obama referenced our research to state that the ACA was a major reason for the prevention of 50,000 patient deaths across the United States, which earned a Geppetto checkmark for accuracy in the Washington Post.

QUOTES FROM CLIENTS

“As a result of Qualidigm’s partnership with our organization and their ongoing expertise, we were able to successfully gain PCMH Level III recognition for 26 of our primary care locations already and are in the process of submitting applications for seven additional locations this year. We are very satisfied with Qualidigm as an organization, and can attest to the excellent timely and responsive technical assistance they provided.” – Client, City Medical Group
“Qualidigm provided us with real time examples of what we should be doing in our practice. They dissected the NCQA guidelines and provided on-site support to help us achieve PCMH recognition. Qualidigm understands that PCMH is the way of the future. They have taken a vested interest in helping practices get up to speed which only helps all of us in the long run and more importantly, it helps the patient.” – Client, physician

DOMAINS:

Actuarial and Financial

Care Coordination/Integration

Community-Based Care and Social Determinants of Health

Consumer Engagement

Flexible Services

Health Information Technology (HIT)

Performance Improvement

Population Health Management

Workforce