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Goals of the Centers for Medicare & Medicaid Services

The term “Network” is used to refer to the ESRD Network contractor, which shall be a QIO-like entity. The tasks are intended to align Network activities with the Department of Health and Human Services (HHS) National Quality Strategy (NQS), the HHS Secretary Priorities (the Opioid Crisis, Health Insurance Reform, Drug Pricing, Home ESRD Treatment Initiative (https://www.cms.gov/newsroom/press-releases/hhs-transform-care-delivery-patients-chronic-kidney-disease) and Value-Based Care ) and the Centers for Medicare & Medicaid Services (CMS) goals that mirror the Secretary’s priorities and other CMS priorities designed to result in improvements in the care of individuals with ESRD.

The CMS Goals:

  • Goal 1:  Empowering patients to make decisions about their health care
  • Goal 2:  Increasing state flexibility
  • Goal 3:  Developing innovative approaches to improving quality, accessibility & affordability
  • Goal 4:  Improving the customer experience

The Network shall promote positive change relative to Secretary’s priorities and CMS goals. The HHS Priorities are interpreted for purposes of this SOW as:

  • Priority 1:  Opioid Crisis
  • Priority 2:  Health Insurance Reform
  • Priority 3:  Drug Pricing
  • Priority 4:  Value-Based Care

Role of the Network

The Networks are critical to achieving bold CMS goals for healthcare transformation and the aims of NQS, the HHS Secretary’s priorities, and CMS goals.

The successful Networks shall be patient care navigators and lead transformation by:

  • Serving as conveners, organizers, motivators, and change agents;
  • Leveraging technology to provide outreach and education;
  • Serving as partners in quality improvement with patients, practitioners, healthcare providers, other healthcare organizations, and other stakeholders;
  • Securing commitments to create collaborative relationships with other stakeholders and partners
  • Achieving and measuring changes at the patient level through data collection, analysis, and monitoring for improvement;
  • Disseminating and spreading best practices including those relating to clinical care, quality improvement techniques, and data collection through information exchange; and
  • Participating in the development of a CMS national framework for providing emergency preparedness services for the ESRD community.

The Network is uniquely positioned to ensure full participation of the ESRD community in achieving the aims of the NQS, HHS Priorities, and CMS Goals.