The Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, determines the priority areas of focus for QIO program resources. The next QIO program cycle, known as the 9th Scope of Work (SOW), is August 2008 – July 2011. The 9th SOW encompasses three main themes: Patient Safety, Prevention and Beneficiary Protection. Our objectives under each of these themes are:

Patient Safety Priorities

• Prevent and treat pressure ulcers in nursing homes and hospitals
• Improve surgical care 
• Reduce restraint use in nursing homes 
• Improve drug safety 
• Reduce Methicillin-resistant Staphylococcus aureus (MRSA)

Prevention Priorities 

Provide technical assistance for physicians using electronic health records improve preventive care for colorectal and breast cancer, influenza and pneumonia.

Beneficiary Protection Priorities

• Perform statutorily-mandated review activities, which include addressing patient complaints and appeals 
• Develop links between case review and quality improvement focusing on opportunities for system-wide change 
• Support hospitals in submission of quality data for reporting and payment purposes

In the 9th SOW, QIOs will work with health care providers identified by CMS as having the greatest need for improvement. QIOs will increase focus on improving quality performance throughout the continuum of care, shifting from a focus on individual settings of care. In addition, national priorities intertwined in the QIO program are promoting the adoption and use of health information technology, reducing health disparities and supporting value-driven health care, which aims to increase the value and transparency of America’s health care.

Resources:

Medicare QIO Program: www.cms.hhs.gov/QualityImprovementOrgs
Department of Health and Human Services: www.hhs.gov/valuedriven/
MedQIC: www.QualityNet.org/medqic