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The Quality Improvement Organization (QIO) Program is a key component of the Centers for Medicare and Medicaid Services' (CMS)’ broad agenda to improve care for Medicare beneficiaries. CMS’ quality agenda includes public reporting of quality measures, known as National Quality Initiatives, to help Medicare beneficiaries make informed choices about local healthcare services.

National Quality Initiatives:

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    		•  National Pneumonia Project
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    		•  National Surgical Infection Prevention Project

    CMS is working to achieve these strategies through partnerships with public and private organizations and through its national network of 53 QIOs representing every U.S. state, territory and the District of Columbia. CMS has contracted with the QIO in each state to work intensively with a group of local providers, called identified participants, to improve care. For more information on QIOs, visit http://www.MedQIC.org. The QIO Program employs four key strategies with providers to achieve the vision of the right care for every person every time:


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    		•  Measure and Report Performance – Measure performance to identify opportunities for improvement and to track progress. Report results for quality improvement, public reporting, pay-for-performance, and accreditation with appropriate provider consents.
     
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    		•  Adopt Health Information Technology – Adopt health information technology to include effectively implementing electronic health records, e-prescribing, computerized physician order entry, teleheath, and other technology to support decision-making and work processes.
     
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    		•  Redesign Care Processes – Implement changes to processes including care management, patient selfmanagement, flow, and scheduling using a variety of methods such as lean and human factors design. Redesign processes for fundamental, rather than additive, changes.
     
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    		•  Transform Organizational Culture – Create a person-centered organizational structure, workforce, and environment that strives for perfection. Empower leaders and staff to create transformational improvement through open communication and teamwork.

    Current National QIO Program Priorities QIO Program priorities are aligned with the agency’s public reporting and pay-for-performance initiatives, and other strategies set forth in CMS’ Quality Roadmap. CMS works continuously with major stakeholders to align the QIO Program with the quality improvement activities of national and local partners and stakeholders.

    CMS contracts with QIOs to assist home health agencies, hospitals, nursing homes and physician offices. Priority topics within these four settings reflect opportunities to improve processes, outcomes and efficiency of care for the Medicare population, and the feasibility of measuring quality of care. CMS also has directed QIOs to work with physician offices to reduce healthcare disparities among racial/ethnic populations.


    Home Health Agencies
     
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    		•  Reduce Acute Care Hospitalizations
     
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    		•  Increase Immunization Screening for Flu and Pneumonia
     
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    		•  Change Organizational Culture to Support Quality Improvement
     
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    		•  Implement Telehealth Technology


    Hospitals
     
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    		•  Improve care for patients with:
        ∗ Acute Myocardial Infarction  
        ∗ Heart Failure  
        ∗ Pneumonia  
     
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    		•  Improve Care through the Surgical Care Improvement Project (SCIP)
     
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    		•  Implement Computer Physician Order Entry
     
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    		•  Implement Bar Coding System
     
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    		•  Change Organizational Culture to Support Quality Improvement
     
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    		•  Improve Care in Rural and Critical Access Hospitals


    Nursing Homes
     
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    		•  Reduce High Risk Pressure Ulcers
     
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    		•  Decrease the Use of Physical Restraints
     
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    		•  Improve Depression Management
     
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    		•  Improve Chronic Pain Management
     
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    		•  Survey Resident and Staff Satisfaction
     
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    		•  Change Organizational Culture to Support Quality Improvement


    Physician Offices
     
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    		•  Promote Information Technology and Electronic Health Records (EHRs)
     
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    		•  Redesign Processes to Support Quality Improvement
     
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    		•  Improve care for patients with:
        ∗ Diabetes  
        ∗ Coronary Artery Disease  
        ∗ Heart Failure  
        ∗ Hypertension  
        ∗ End Stage Renal Disease  
     
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    		•  Increase Preventative Care
        ∗ Adult Immunization  
        ∗ Blood Pressure Measurement  
        ∗ Breast Cancer Screening  
        ∗ Colorectal Cancer Screening  
        ∗ LDL Cholesterol Level  
        ∗ Tobacco Use Counseling