Led by the Centers for Medicare & Medicaid Services (CMS), the Quality Improvement Organization (QIO) Program is one of the largest federal programs dedicated to improving health quality at the community level for people with Medicare. We support a person-oriented model of care and help reduce provider burden, so they can spend more time focusing on patients.
The 14 regional QIN-QIOs work with health care providers, community partners, beneficiaries, and caregivers on data-driven initiatives designed to improve the quality of care for people with specific health conditions.
The two BFCC-QIOs help Medicare beneficiaries exercise their right to high-quality health care by addressing concerns and appeals, quality of care reviews, cases of suspected “patient dumping” covered by the Emergency Medical Treatment and Labor Act (EMTALA), and other types of care review.
Throughout its mission, the QIO Program aligns with the six priorities of the CMS Meaningful Measures Framework:
- Make care safer by reducing harm caused in the delivery of care.
- Strengthen person and family engagement as partners in their care.
- Promote effective communication and coordination of care.
- Promote effective prevention and treatment of chronic disease.
- Work with communities to promote best practices of healthy living.
- Make care affordable.