CMS released its response to the IOM study on QIOs yesterday. Both the study and the response were mandated by the MMA. The IOM study recommended that the mission of the QIOs be refocused on technical assistance to providers. More specifically, the IOM’s report brief noted in part:
The expansion of public reporting on the performance of health care organizations and practitioners, along with the growth of incentive programs designed to raise quality levels, will increase demand by health care providers for the type of expert assistance that QIOs offer. To meet this anticipated surge in demand, the IOM recommends that QIOs refocus all of their efforts toward quality improvement technical assistance. QIOs should concentrate on helping providers improve their delivery of care, their organizational cultures, and information systems instead of handling beneficiary complaints, appeals, and other case reviews. QIO technical assistance activities cover five dimensions:
• Improvement of care documented by statewide performance measures (e.g., rate of mammography screening for appropriate populations)
• Improvement in provider capability to gather data and report on performance measures
• Adoption and use of improved systems (e.g., electronic health record)
• Changing the way care is delivered or assessed (e.g., required assessments of immunization status of the elderly by home health agencies)
• Monitoring and changing organizational culture (e.g., turnover rate of staff, satisfaction of residents and staff of nursing homes).
CMS describes the QIO program and its planned new initiatives in summary form here. The key buzzword is "patient-centered care." The full report is worth a quick read in order to get a sense of CMS’s priorities for QIOs and their interaction with providers.
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