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Case Review Connections

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A Newsletter for Healthcare Providers and Stakeholders

Post-acute Care Edition
Issue 40: March 2024

Do you receive the Case Review Connections newsletter?
If not, sign up for Kepro's email list to receive important news and updates as well as the bi-monthly newsletter.

If you want to communicate BFCC-QIO information, please email Kepro at QIOCommunications@kepro.com and request a newsletter insert or fact sheet for your organization. Please do not copy and paste information from Case Review Connections.

join us for a webinar about kepro's services

Join our Outreach staff for an informative webinar about Kepro on Tuesday, March 26, 2024.

This webinar will provide basic information about the services that Kepro offers for Medicare beneficiaries, including hospital discharge and skilled service termination appeals, quality of care complaints, and Immediate Advocacy.

Register for the Webinar

If you have difficulty registering, send an email to QIOCommunications@kepro.com.

Aging Health Matters Podcastnew podcast episode about end-stage renal disease (esrd)

In this podcast episode, you will learn about ESRD, how it is diagnosed, and why ESRD is important to Medicare. You will also hear about the ESRD Network as well as other Medicare contractors that work with ESRD. 

in this issue:

medical director's corner - jessica whitley, md, mba

Kepro produces Annual Reports as required by the Centers for Medicare & Medicaid Services (CMS). These reports provide important information about the volume and outcomes of Kepro’s review activity. Recently, Kepro posted the latest reports, which cover January 1, 2023, through October 31, 2023. There are individual reports for each of Kepro’s five Regions, and at the end of each report, there is state-specific information.

The Annual Reports include the total volume of reviews by review type, the confirmed quality of care concerns, and category codes to describe the type of concern. There is information regarding the quality of care concerns that were referred to the Quality Innovation Network Quality Improvement Organization (QIN-QIO). Additionally, the Annual Reports show facts about appeals, the percentage of agree/disagree rates, and much more.

Immediate Advocacy is used to help people quickly resolve a problem about medical care or services. Therefore, Immediate Advocacy success stories are highlighted. These show how the process can be useful to both beneficiaries and providers. Finally, collaborations by our Outreach staff with stakeholders across their Regions are shared. 

Improving the quality of care that Medicare beneficiaries receive throughout the provider system is a top priority. The data in these reports are used to assist with these efforts.

Get the report for your region.

appeals update

On weekends and holidays, Kepro will now be available from 10 am – 4 pm (in each local time zone) to take appeals calls. Previously, the hours were from 11 am – 3 pm.

Reminder: Kepro had a webinar on appeals in November. The Q&A from that session is available on our website.

cms conferences

Quality Conference: "Resilient and Ready Together: Creating an Optimal Environment for Quality Healthcare for Individuals, Families, and Communities." 

April 8 - 10, 2024

This conference will have eight unique tracks focusing on the following topics. Kepro will also be presenting!

  • Advancing health equity
  • Collecting and using quality data
  • Engaging partners and communities
  • Expanding access to quality and affordable behavioral and physical health care
  • Healthcare system resiliency and readiness
  • High reliability and quality improvement
  • New technology and innovation
  • Patient safety

Health Equity Conference

May 29 - 30, 2024

During this conference, CMS leadership will present information on recent developments and updates to CMS programs. Also, the latest health equity research, promising practices and creative solutions, and community engagement strategies will be shared.

health equity

One of the priorities for CMS is to advance health equity. CMS has put together a framework of priorities for the next 10 years. These priorities include:

Priority 1: Expand the collection, reporting, and analysis of standardized data

Priority 2: Assess causes of disparities within CMS programs and address inequities in policies and operations to close gaps

Priority 3: Build capacity of healthcare organizations and the workforce to reduce health and healthcare disparities

Priority 4: Advance language access, health literacy, and the provision of culturally tailored services

Priority 5: Increase all forms of accessibility to healthcare services and coverage 

spanish and chinese resources

Kepro now has a newsletter insert available in both Spanish and Chinese that gives an overview of our services. The information can be shared in newsletters or on your organization’s website. This document includes three different versions of varying lengths. If your organization has a newsletter in Spanish or Chinese, please check it out!

acentra health

Same services, but with a new name and look! Kepro will soon be known as Acentra Health. During this rebrand, case reviews and all other services will continue without interruption with the same quality and dependability we have always provided. Providers will be encouraged to update beneficiary notices by replacing “Kepro” with “Acentra Health,” but notices with the QIO name of “Kepro” listed will still be accepted and validated. Stay tuned for exciting new updates! For more information about our name change and the minimal impact it has on the Medicare providers, stakeholders, and beneficiaries we serve, please visit our FAQ webpage

march health observance - national nutrition month®

During the month of March, learn about making informed food choices and developing healthy eating and exercise habits. The theme for this year's observance is "Beyond the Table." 

Publication No. R146810-344-3/2024. This material was prepared by Kepro, a Medicare Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 

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