9th Scope of Work Overview
QSource continues to assist providers with improving their quality of care through the renewal of our Medicare contract as the quality improvement organization for Tennessee. Emphasis areas under our 9th Scope of Work (9SoW) contract include:

Beneficiary Protection
Individual patient complaints and provider medical record reviews are important starting points for analysis of quality care by providers and practitioners. Activities QSource will conduct include:

• Case reviews
• Quality improvement activities (QIAs)
• Alternative dispute resolution (ADR)
• Sanction activities
• EMTALA review
• Physician acknowledgement monitoring
• Collaboration with other CMS contractors
• Promoting transparency through reporting
• Quality data reporting
• Communication (education and information)

Patient Safety
QSource will address areas of patient harm to improve safety by improving healthcare processes and systems. In this effort, activities will continue to focus on surgical care, heart failure, pressure ulcers and physical restraints in nursing homes, and drug safety. New areas included in the 9SoW include MRSA, pressure ulcer prevention in hospitals, and QIO technical assistance for nursing homes in need.

Prevention
QSource will work to improve the quality and frequency of preventive healthcare services is to optimize beneficiary quality of life and healthcare efficiencies. QSource activity in this area include assisting providers with an EHR in monitoring rates for mammograms, colorectal cancer (CRC) screenings and influenza and pneumococcal immunizations.

Chronic Kidney Disease (CKD)
QSource’s main focus for this effort is the early detection of kidney disease in diabetic beneficiaries, appropriate medication and screening to slow its progression and adequate counseling prior to the initiation of dialysis. Activities include provider and beneficiary education about risk factors, early identification and treatment choices for CKD.