Medicare's Quality Improvement Organization (QIO) Program is the largest federal program dedicated to improving health quality at the community level. QIOs in every state and territory, united in a network administered by CMS, have the flexibility to respond to local needs.
From August 2011 through July 2014, health care providers and other quality stakeholders are invited to support Four Program Aims:
Improve Individual Patient Care.
Patient safety initiatives in hospitals will reduce central line bloodstream infections by implementing the Comprehensive Unit-Based Safety Program (CUSP), then expand to encompass catheter-associated urinary tract infections, Clostridium difficile and surgical site infections. All Medicare-participating hospitals also will receive technical assistance for reporting inpatient and outpatient quality data to CMS.
In nursing homes, work initially targets pressure ulcers and physical restraints, then evolves to address other health care-acquired conditions, preventive services and culture change topics such as staff retention.
To decrease adverse drug events, Quality Improvement Organizations are bringing community pharmacists, physicians and facilities together in local Patient Safety Clinical Pharmacy Services Collaboratives (PSPC), following the successful HRSA model.
Download CMS overview of Improving Individual Patient Care Aim.
Improve Health for Populations and Communities.
QIOs are assisting physician practices that want to use their electronic health record system to coordinate preventive services and report related quality measures to CMS. Practices also can participate in a learning network focused on reducing patient risk factors for cardiac disease. QIOs will partner with their local Health Information Technology Regional Extension Center (REC) to promote health IT integration into clinical practice.
Download CMS overview of Improving Health for Populations and Communities Aim.
Integrate Care for Populations and Communities.
QIOs are bringing together hospitals, nursing homes, patient advocacy organizations and other stakeholders in community coalitions. Goals are to build capacity for improving care transitions and to support the coalition’s success in obtaining grant funding through Section 3026 of the Affordable Care Act.
Download CMS overview of Integrating Care for Populations and Communities Aim.
Deliver Beneficiary and Family Centered Care.
QIO Program improvement initiatives result in safer, more effective patient care, lead to better health for populations and communities, and drive lower health care costs through improvement. QIOs also fulfill CMS’ obligation to protect the rights of Medicare beneficiaries by reviewing complaints about quality and appeals about the denial or discontinuation of health care services.
Download CMS overview of Beneficiary and Family Centered Care Aim.