In the Mainstream: QSource’s Portfolio Expands Well Beyond Government Contract Work on Memphis Medical News

In the Mainstream: QSource’s Portfolio Expands Well Beyond Government Contract Work

By: LYNNE JETER

Dawn FitzGerald

When Memphis-based QSource was unveiled as the Health Information Technology (HIT) Regional Extension Center (REC) for Tennessee as part of a $1 billion American Recovery & Reinvestment Act investment, some business leaders unfamiliar with its work believed it might be a new company formed to provide local technical assistance to effectively implement electronic health records (EHRs) and associated healthcare quality improvement.

Not so.

QSource, a not-for-profit organization, has been around since 1973, when it was established as the Mid-South Foundation for Medical Care (MSFMC) to serve as the Medicare Professional Standards Review Organization (PSRO) for West Tennessee.

As the REC for Tennessee, QSource—among 70 entities selected by the Office of the National Coordinator for Health Information Technology—will provide workforce development-training, group purchasing of EHRs, onsite technical assistance, office workflow redesign, health information exchange (HIE) interoperability, privacy and security training and progress toward the “meaningful use” of EHRs.

To grow from a company deriving 95 percent of its revenues from federal government contracts to a diversified healthcare business leader attributing only 45 percent to state and federal government contracts, QSource experienced landmark changes:

When the Commission on the Peer Review Improvement Act of 1982 dismantled the PSRO structure and authorized the use and quality control Peer Review Organization (PRO) program, MSFMC became the PRO for Tennessee.
From 1986 until the state enacted TennCare, a managed care program, in 1994, QSource oversaw the state’s Medicaid program. The company contracted with CMS to serve as the national Disadvantaged Populations Support PRO, later known as the Underserved Quality Improvement Organization Support Center (UQIOSC).
When CMS changed the mission of its contractors from PRO to QIO and launched a national public reporting initiative involving QIO oversight, the MSFMC name was changed to QSource to reflect the company’s mission.
In 2008, the company established the subsidiary, QSource of Arkansas, and contracts with that state to provide therapy review and prior authorization services for Medicaid recipients under the age of 21, among other activities.

“QSource has been working with healthcare providers’ offices for almost four decades, yet we realize we’re not well known outside the community we serve, partly as a result of not marketing or branding QSource as an organization,” said QSource CEO Dawn FitzGerald. “We’ve been primarily funded through the federal government to provide quality improvement services free of charge, which has really not required us to brand and market who we are as an organization and the services we provide. There’s probably been some intentionality to the fact that we’re a—I like to call us—stealth organization. It’s hard to stick around for 30 years and have very few people really know all the services you provide, but we’ve done very well at that.”

Five years ago, QSource took the initiative to achieve certification as an ISO 9001:2001 company. “We wanted to do this, even though none of our contracts required ISO certification, because we were experiencing a great deal of growth,” said FitzGerald, pointing out that separate from ISO performance standards, most QSource state and federal contracts call for performance expectations that rely on individual healthcare entities, such as hospitals and nursing homes, to improve performance on quality measures. “We have a very low turnover, so the existing staff knew their jobs really well, but we were infusing new staff and new contract activities. We knew we couldn’t rely on the knowledge solely of our existing staff to train new staff. We had to start thinking about writing work instructions and flow-chart processes so that someone who isn’t as familiar with the organization can pick it up more readily. It does force you as an organization to look at how you provide a service and then write that process down so it can be replicated consistently over and over again.”

QSource services now include quality assurance, quality improvement, program evaluation, HIT, data aggregation, data analysis, and communication/education services to physicians, hospitals, nursing homes, home health agencies and other healthcare providers. The company specializes in contract work involving underserved and disadvantaged populations, public reporting, claims coding and complaints, and beneficiary assistance and appeals. In-house clinical experts address issues ranging from healthcare reform and HIT to nursing home care, surgical infections, and MRSA.

QSource also provides services to partners such as the Tennessee Hospital Association and Healthy Memphis Common Table.

“They’re very good partners,” said FitzGerald. “For example, Healthy Memphis Common Table is doing the right thing in our community in terms of trying to get the word out about healthcare quality, choosing the right doctor, making the right healthcare choices as an individual. On one level, we provide some infrastructure through an agreement to sublease office space and provide some administrative resources. On the other level, we’re contracted as their data aggregator, so we aggregate the health plan data for their public reporting initiative.”

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