MDS Alert

Published on Wed Feb 20, 2013 PDF

CMS Quality Improvement Organizations can help you improve care and reduce costs.

Do you know who your QIO is? If not, you’re missing out on a great resource that can help you develop and implement a strategy for improving quality in your facility. QIOs, or Quality Improvement Organizations, are private, mostly not-for-profit groups, staffed primarily by doctors and other health care professionals, who are trained to review medical care, respond to complaints, and implement improvements in quality throughout the spectrum of care.

CMS contracts with one QIO in each state, as well as the District of Columbia, Puerto Rico, and the US Virgin Islands, notes Jean Moody Williams, director of the Centers for Medicare & Medicaid Services (CMS) quality improvement group. "QIOs really work through the grassroots level to accomplish CMS’ goals of improving quality and achieving value for the taxpayer dollar," Williams explained during the CMS Special Open Door Forum, "The Future Development of the QIO Program," on January 24^th.

Don’t get left behind

CMS firmly believes that quality improvement will lead to lower costs with the provision of better care and reduced waste, she noted. "We view this as an urgent issue and look to the QIOs to be our change agents and conveners for widespread, significant improvements in health quality," Williams said.

QIOs base their work on clinical evidence and generate extensive, reliable data about clinical performance. For instance, the QIOs have been working with nursing homes on reducing the rate of pressure ulcers and the use of antipsychotic drugs, helping to identify best practices. "There’s some excellent care that’s being delivered, and we look to see how we can spread those promising practices that do exist," Williams added.

Adopt a culture of learning

Looking to the future, the QIOs are focusing on helping providers implement a culture of learning based on the Institute of Medicine’s findings in its report, "Best Care at Lower Cost: The Path to Continuously Learning Health Care in America." The pillars of this culture include real-time access to knowledge, digital capture of care experiences, patient-centered care, growth through continuous feedback and refinement and incentives that reward for value.

"We envision a future in which the QIOs are maximizing learning and collaboration, and improving care as we partner at the local, state and regional levels where we’re delivering program value to beneficiaries, patients and taxpayers," Williams explained. "While we have already seen improvement in quality, we need to meet our goals faster . . . we can’t waste time," she emphasized.

Editor’s note: More information on what QIOs are and what they do is available at: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityImprovementOrgs/index.html.

The directory of QIOs and contact details are available at: www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic/Page/QnetTier2&cid=1144767874793.