The QIO program continues to evolve as it remains dedicated to improving health care quality in key priority areas identified by the Centers for Medicare & Medicaid Services.  The next QIO program contract cycle, known as the 9th Scope of Work (SOW), will encompass four themes: Patient Safety, Prevention, Beneficiary Protection and Care Transitions.  Woven into each of these themes are components of health information technology and health care disparities.  The 9th SOW is slated to begin in August of 2008.

Much of the work going forward will build on the successes and challenges we have already been working on in partnership with Oklahoma health care providers.  For example, the Patient Safety Theme will focus QIOs on continued work in preventing and treating pressure ulcers, reducing restraint use, improving drug safety and preventing surgical infection.  Methicillin-resistant Staphylococcus aureus, (MRSA) has been factored into the 9th SOW to use proven interventions to reduce harm to patients.

In the Prevention Theme, we will continue to provide technical assistance to physicians using electronic health records to prevent or slow the progression of chronic disease, such as diabetes, cancer and chronic kidney disease. We will also have opportunities to identify and reduce health care disparities in minority and underserved populations.

QIOs will continue to serve beneficiaries through statutorily-mandated review activities, which include expeditiously addressing complaints and appeals. Also as part of the Beneficiary Protection Theme, we will increase the link between quality improvement activity and our case review work focusing on opportunities for system-wide change.

The Care Transitions Theme will position QIOs to help create better systems of care as Medicare patients go from one setting to the next. This work includes reducing unnecessary hospitalizations that can harm patients and drain the Medicare Trust Fund.

CMS will direct QIO resources to providers throughout the country that have demonstrated though performance measures the greatest need or opportunity for improvement.  This focused approach will help ensure the QIO program benefits and impacts those providers and beneficiaries who need it most.

The 9th SOW is sure to pose new challenges and opportunities as we work with providers in every setting of care. Please stay tuned as the details of implementing this work in Oklahoma are unveiled in the coming months.