Guest guest Posted January 5, 2008 Report Share Posted January 5, 2008 Cross post. Fascinating - hadn't heard of the QIO's. Good goals -- the right care for every person every time Locke, MD =================================================== http://www.cms.hhs.gov/QualityImprovementOrgs/ Overview Under the direction of CMS, the Quality Improvement Organization (QIO) Program consists of a national network of 53 QIOs, responsible for each U.S. state, territory, and the District of Columbia. QIOs work with consumers and physicians, hospitals, and other caregivers to refine care delivery systems to make sure patients get the right care at the right time, particularly patients from underserved populations. The Program also safeguards the integrity of the Medicare Trust Fund by ensuring that payment is made only for medically necessary services, and investigates beneficiary complaints about quality of care. Quality Improvement Work To achieve the vision of the QIO Program, the right care for every person every time, the Program assists providers in transforming quality to make healthcare: Safe Effective Patient-Centered Timely Efficient Equitable Through QIOs and End-Stage Renal Disease (ESRD) Networks, and in partnership with other stakeholders, the Program assists providers in transforming healthcare quality, and protects beneficiaries and the Trust Fund, using the following strategies: Measure and report performance Adopt healthcare information technology and use it effectively Redesign process Transform organizational culture Beneficiary Protection CMS contracts with the QIOs to conduct case review to ensure that care provided to Medicare beneficiaries meets professionally recognized standards of healthcare and that Medicare pays only for services that are reasonable and necessary. The Beneficiary Complaint Response Program has a systematic approach to identifying quality concerns. The emphasis of the Beneficiary Complaint Response Program is on ways to work with the physicians and practitioners in the community so together we can improve the quality of care for the Medicare beneficiaries. QIOs are required to conduct individual case review in the following categories: Potential antidumping violations Assistants at cataract surgery Beneficiary complaints, notices, and appeals Hospital and Managed Care Plan notices of non-coverage Potential concerns identified during project data collection Hospital-requested higher-weighted diagnosis related group (DRG) adjustments The Report to Congress in the Downloads area outlines improvements, based on an extensive CMS review and IOM recommendations, to strengthen Medicare's oversight and evaluation of the Medicare Quality Improvement Organization Program to better meet the future needs of beneficiaries and health care providers. Home QIO Listings QIO Listingsfunction jumpTo(URL_List){ var URL = URL_List.options[url_List.selectedIndex].value; window.location.href = URL; } State: select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine land Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming State Organization and Website Link Telephone Number Alabama AQAFwww.aqaf.com Alaska Mountain-Pacific Quality Health Foundationwww.mpqhf.org Arizona Health Services Advisory Groupwww.hsag.com Arkansas Arkansas Foundation for Medical Carewww.afmc.org California Lumetra www.lumetra.com Colorado Colorado Foundation for Medical Carewww.cfmc.org Connecticut Qualidigmwww.qualidigm.org Delaware Quality Insights of Delawarewww.qide.org District of Columbia Delmarva Foundation for Medical Carewww.delmarvafoundation.org Florida FMQAIwww.fmqai.com Georgia Georgia Medical Care Foundationwww.gmcf.org Hawaii Mountain-Pacific Quality Health Foundationwww.mpqhf.org Idaho Qualis Healthwww.qualishealth.org Illinois Illinois Foundation for Quality Health Carewww.ifqhc.org Indiana Health Care Excelwww.hce.org Iowa Iowa Foundation for Medical Carewww.internetifmc.com Kansas Kansas Foundation for Medical Carewww.kfmc.org Kentucky Health Care Excelwww.hce.org Louisiana Louisiana Health Care Reviewwww.lhcr.org Maine Northeast Health Care Quality Foundationwww.nhcqf.org land Delmarva Foundation for Medical Carewww.delmarvafoundation.org Massachusetts MassPROwww.masspro.org Michigan MPROwww.mpro.org Minnesota Stratis Healthwww.stratishealth.org Mississippi Information and Quality Healthcarewww.iqh.org Missouri Primariswww.primaris.org Montana Mountain-Pacific Quality Health Foundationwww.mpqhf.org Nebraska CIMRO of Nebraskawww.cimronebraska.org Nevada HealthInsightwww.healthinsight.org New Hampshire Northeast Health Care Quality Foundationwww.nhcqf.org New Jersey Healthcare Quality Strategies, Inc. www.hqsi.org New Mexico New Mexico Medical Review Associationwww.nmmra.org New York IPROwww.ipro.org North Carolina The Carolinas Center for Medical Excellencewww.mrnc.org North Dakota North Dakota Health Care Reviewwww.ndhcri.org Ohio Ohio KePROwww.ohiokepro.com Oklahoma Oklahoma Foundation for Medical Qualitywww.ofmq.com Oregon Acumentra Healthwww.acumentra.org Pennsylvania Quality Insights of Pennsylvaniawww.qipa.org Puerto Rico Quality Improvement Professional Research Organizationwww.qipro.org Rhode Island Quality Partners of Rhode Islandwww.riqualitypartners.org South Carolina The Carolinas Center for Medical Excellencewww.mrnc.org South Dakota South Dakota Foundation for Medical Carewww.sdfmc.org Tennessee QSourcewww.qsource.org Texas TMF Health Quality Institutewww.tmf.org Utah HealthInsightwww.healthinsight.org Vermont Northeast Health Care Quality Foundationwww.nhcqf.org Virgin Islands Virgin Islands Medical Institutewww.vimipro.org Virginia Virginia Health Quality Centerwww.vhqc.org Washington Qualis Healthwww.qualishealth.org West Virginia WVMI Quality Insightswww.wvmi.org Wisconsin MetaStarwww.metastar.com Wyoming Mountain-Pacific Quality Health Foundationwww.mpqhf.org Quote Link to comment Share on other sites More sharing options...
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