What Are QIOs?
Quality Improvement Organizations
Medicare Quality Improvement Organizations (QIOs) are Medicare’s “Boots on The Ground” to drive and champion improvement in our nation’s health care system. Working on behalf of the Centers for Medicare & Medicaid Services (CMS) since 1984, QIOs are an independent and objective voice to help improve health care delivery, safety, and efficiency in every U.S. state and territory through a combination of:
- Improvement collaboratives with local health care providers and provider organizations
- Targeted assistance for individual health care providers
- Direct intervention with Medicare beneficiaries and the health care community
- Serving as conveners
The QIOs are grouped into 14 Quality Innovation Networks which together are known as QIN-QIOs.
How QIOs improve patient care
QIOs are private, mostly not-for-profit, organizations staffed by teams of physicians and other health care quality experts. QIOs work directly with health care providers—such as hospitals, physicians, nursing homes, and home health agencies—to ensure the most current, clinically proven techniques and practices are being put in place to deliver the safest and highest quality care.
QIOs serve as local leaders and conveners, mobilizing state wide efforts to support the U.S. Department of Health and Human Services’ National Quality Strategy and broad national health care improvement goals such as reducing health care associated infections and health care acquired conditions; reducing deaths from heart attack and stroke; improving preventive care; and broadening the use of electronic health records.
QIOs analyze data and patient records to identify areas for improvements in care, and ensure patients’ voices are being heard by addressing individual complaints and bringing their perspectives into the improvement process.
In addition to improving health care for the nation’s 49 million (link is external) Medicare beneficiaries, QIOs work with federal, state, and local governments as well as private entities, and serve as critical resources for state Medicaid agencies. Some of the many services QIOs offer include health care information technology (IT) consulting, quality review services, dispute resolution services, and other health care improvement service lines. Many QIOs also serve as health IT Regional Extension Centers (link is external) (RECs), working with physician practices to help them use electronic health records as tools for health care improvement.