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From Health Law Daily, May 12, 2014

CMS launches restructured Quality Improvement Organization Program

By Greg Hammond, JD

CMS has announced the launch of its improved Quality Improvement Organization (QIO) Program to improve patient care and health outcomes, while reducing health care costs. “The QIO program is an integral part of the U.S. Department of Health and Human Services’ national quality strategy for providing better care, better health at lower costs, and providing ‘boots on the ground’ technical assistance through a national network of independent organizations working to improve care delivery at the community level,” the agency stated in a press release. The program is a continuation of the agency’s efforts to improve health care quality, pursuant to the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148).

Two phases. According to CMS, the restructured QIO program will be implemented in two phases. During the first phase, two Beneficiary and Family-Centered Care (BFCC) QIO contractors, Livanta LLC and KePRO, will support the program’s case review and monitoring activities to ensure consistency in the review process, while considering local factors that are important to beneficiaries. The second phase of the program will involve the awarding of contracts to organizations that will work on quality initiatives directly with providers and communities.

“One of the most critical roles of CMS is to protect the quality and safety of care delivered to beneficiaries. Care needs to be patient-centered and directly engage patients, families, and caregivers,” stated CMS deputy administrator and chief medical officer Dr. Patrick Conway. “The quality of care review is essential to ensure care delivered to all beneficiaries meets professionally recognized standards.”

AHQA. American Health Quality Association (AHQA) Executive Director Todd Ketch, released a statement in support of CMS’ QIO program efforts. “We commend the Centers for Medicare & Medicaid Services (CMS) for restructuring the Quality Improvement Organization (QIO) Program and committing to maintaining the work and focus of the QIOs at the community level,” Ketch said. “The contracting structure for the QIOs is changing but the focus remains the same, which is to drive health care quality improvement locally.” He further noted, “We applaud CMS’ commitment to continuing to provide boots-on-the-ground QIO technical assistance that has been integral to national quality improvement efforts, and we look forward to the QIOs driving even greater improvements in care delivery at the community level in the years ahead.”

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