Medicare's Quality Improvement Organization Program

Medicare's Quality Improvement Organization Program is the second book in the new Pathways to Quality Health Care series. Focusing on performance improvement, it considers the history, role, and effectiveness of the Quality Improvement Organization (QIO) program and its potential to promote quality improvement within a changing health care delivery environment that includes standardized performance measures and new data collection and reporting requirements. This book carefully examines the QIOs that serve every state as well as the national program that guides and supports them. In addition, it highlights the important roles that a national program with private organizations in each state can play in promoting higher quality care. Medicare's Quality Improvement Organization Program looks closely at the technical assistance role of the QIO program and the need to encourage and support providers to improve their performance. By providing an in-depth assessment of the federal experience with quality improvement and recommendations for program improvement, this book helps point the way for those who strive to create higher quality and better value in health care. Intended for multiple audiences, Medicare's Quality Improvement Organization Program is essential reading for members of Congress, the federal executive branch, the QIOs, health care providers and clinicians, and stakeholder groups. Table of Contents Front Matter Summary Introduction Part I--Introduction: 1 A Historical Perspective and the Current QIO Program 2 Assessment of the QIO Program: Findings and Conclusions 3 Performance Measurement, Quality Improvement, and Other Entities 4 Improving Quality and Performance Measurement by the QIO Program 5 CMS Oversight of the Operations and Management of the QIO Program Part II--Introduction: 6 Study Approach 7 Structure and Finances 8 Technical Assistance for Quality Improvement 9 Impact of Technical Assistance for Quality Improvement and Knowledge Transfer 10 Evaluation of Quality Improvement Achieved by the QIO Program 11 Beneficiary Education and Communications 12 Protection of Medicare Beneficiaries and Program Integrity 13 CMS Oversight Appendix A Supporting Tables Appendix B Private Sector Organizations Offering Services Related to Quality Improvement Appendix C Approaches to Evaluation Design Appendix D Glossary and Acronyms Appendix E Committee Biographies Index