New Direction For Quality Improvement Organizations (QIOs)
Statement by AHQA Executive Vice President David Schulke

AHQA is pleased that the Centers for Medicare & Medicaid Services (CMS) is proposing that Quality Improvement Organizations (QIOs) play a central role in promoting fundamental change in the delivery of health care.

Studies show that providers are making steady progress toward better quality, partly as a result of the QIO program’s focus on improving results on specific quality measures. But, progress is not occurring quickly enough to bridge the “quality chasm” identified by the Institute of Medicine over three years ago.

CMS is calling on QIOs during their next contract cycle (2005-2008) to help health care providers transform organizational culture, redesign care processes, and adopt more effective systems of care. QIOs in every state are uniquely positioned to take the lead in their communities—working closely with physicians, hospitals and other health care institutions, and consumers.

We welcome the proposed expansion of QIO efforts designed to increase the pace of change and to have a critical impact on quality of care. These include:

• Providing quality improvement assistance to drug plans created by the Medicare Modernization Act.
• Helping physician offices adopt and effectively use IT for better quality of care.
• Promoting redesign of chronic care management and expansion of preventive care and screening.
• Helping hospitals make major gains in preventing surgical complications.
• Working with hospitals and nursing homes to adopt effective workforce retention programs.
• Helping nursing homes undertake organizational culture change for better resident satisfaction.

AHQA also endorses the CMS proposal for QIOs to help create a new environment for transforming quality of care. QIOs have already begun working with the media and provider groups to help the public realize what’s at stake and encourage all providers to do whatever is necessary so that all of us—as patients—receive the care we should get. As the next three-year contract (known as the 8th QIO Scope of Work) gets underway, QIOs will conduct awareness campaigns to promote widespread changes in attitudes and behavior on the part of both consumers and providers of health care.

Recognizing that the 8th Scope of Work will greatly increase the breadth of QIO work, CMS is asking for comments on how to ensure that expertise is available to carry out all the tasks in the proposed contract. AHQA will be providing suggestions on how CMS can give QIOs the resources and flexibility to assemble the best possible teams and partnerships to fulfill the goals of Medicare’s ambitious quality agenda.