What is a Quality Improvement Organization?

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The Quality Improvement Organization Program is one of the largest federal programs dedicated to improving health quality for Medicare beneficiaries.

It is an integral part of the U.S. Department of Health and Human Services’ National Quality Strategy for providing better care and better health at lower cost.

Led by the Centers for Medicare & Medicaid Services, the Quality Improvement Organization Program is dedicated to improving health quality at the community level for people with Medicare.

It is the engine driving innovative state and local collaborations that result in high-quality, affordable, and person-centered care for America’s Medicare beneficiaries.

There are two types of QIOs: Beneficiary and Family Centered Care (BFCC)-QIOs and Quality Innovation Network (QIN)-QIOs.

The Beneficiary and Family Centered Care (BFCC)-QIOs help Medicare beneficiaries exercise their right to high-quality health care.

They manage all beneficiary complaints including appeals concerning a health care provider’s decision to discharge them from the hospital or discontinue other types of services.

The Quality Innovation Network-QIOs (QIN-QIOs) work together with all community stakeholders to achieve rapid, wide-scale improvements in patient care, increases in population health, and lower health care costs for all Americans.

They use innovation and data to improve the quality of care of Medicare beneficiaries. Their current statement of work will help meet national goals across five aims in nursing homes and community coalitions.

For example, they work to improve nursing home quality by improving infection control, reducing adverse drug events, and reducing emergency room visits and readmissions.

They also provide technical assistance to facilities and clinicians who have an identified opportunity for improvement.

Learn more and find the QIO for your state online.

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