QUALITY IMPROVEMENT ORGANIZATIONS
Quality Improvement Organizations—A CMS Initiative
- Quality improvement organizations (QIOs) are a part of the Centers for Medicare & Medicaid Services (CMS), and are designed to enhance seamless care transitions1,2
- QIOs are contracted with CMS to safeguard the care of Medicare beneficiaries and are assigned in all 50 states3
- QIOs partner with physicians, hospitals, SNFs, and beneficiaries to measure the delivery of high-quality care across the healthcare continuum3
- QIOs measure how often healthcare quality is delivered according to clinical indicators. When care is not up to standard, QIOs collaborate with healthcare providers to improve processes and make suggestions3
- QIO interventions have been proven successful. Between 2002 and 2003, a QIO-led initiative resulted in 56 hospitals nationwide collaborating to prevent surgical infections. Of those, 44 showed a 27% overall improvement in reducing surgical site infections4
- Continuity of care is a major theme of the CMS QIO 9th Statement of Work, which extends through July 2011 and covers the spectrum of care5,6
- Develop a robust framework of quality measures that provides accountability to QIOs for making changes at all levels of the healthcare system
- Implement a management information system that monitors how well QIOs meet programmatic and administration metrics
- Ensure QIO services make positive contributions to beneficiary care and that the best value is received for resources expended
References:
- Medicare announces sites for pilot program to improve quality as patients move across care settings [press release]. Centers for Medicare & Medicaid Web site. http://www.cms.gov/apps/media/press/release.asp?Counter=3439. Published April 13, 2009. Accessed May 11, 2011.
- QIO 9th statement of work executive summary series: Medicare QIOs and care transitions. http://www.ahqa.org/pub/uploads/CMS_SoW9_Summary_Care_Transitions_0807.pdf. Accessed February 16, 2011.
- Fact sheet: Medicare QIOs. American Health Quality Association Web site. http://www.ahqa.org/pub/media/159_766_2687.cfm. Accessed February 1, 2011.
- Dellinger EP, Hausmann SM, Bratzler DW, et al. Hospitals collaborate to decrease surgical site infections. Am J Surg. 2005;190:9-15.
- Medicare QIOs and Care Transitions. American Health Quality Association Web site. http://www.ahqa.org/pub/uploads/CMS_SoW9_Summary_Care_Transitions_0807.pdf. Accessed May 11, 2011.
- Overview of the Medicare post acute care payment reform initiative. Centers for Medicare & Medicaid Services Web site. http://www.cms.gov/DemoProjectsEvalRpts/downloads/PACPR_RTI_CMS_PAC_PRD_Overview.pdf. Accessed May 11, 2011.
