By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: What are QIOs?
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > What are QIOs?
BusinessPolicy & Law

What are QIOs?

JasonShafrin
JasonShafrin
Share
3 Min Read
SHARE

According to the CMS website, Quality Improvement Organizations (QIOs) are private, mostly not-for-profit organizations, which are staffed by professionals, mostly doctors and other health care professionals, who are trained to review medical care and help beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available throughout the spectrum of care. CMS contracts with one organization in each state, as well as the District of Columbia, Puerto Rico, and the U.S. Virgin Islands to serve as that state/jurisdiction’s QIO contractor. QIO’s core functions include:

  • Improving quality of care for beneficiaries;
  • Ensuring that Medicare pays only for reasonable and necessary services and goods in the most appropriate setting; and
  • Addressing individual complaints, such as beneficiary complaints; provider-based notice appeals; violations of the Emergency Medical Treatment and Labor Act (EMTALA) [EMTALA require hospitals and ambulance services to provide care to anyone needing emergency services.]
  • On February 2, 2011, CMS published a proposed rule that would require most Medicare-participating providers and suppliers to give Medicare beneficiaries written notice about their right to contact a Medicare Quality Improvement Organization (QIO) with concerns about the quality of care they receive under the Medicare program.

Examples of work the QIOs perform includes:

  • The Federal Doctor’s Office Quality Information Technology initiative (DOQ-IT). This initative promotes the adoption of electronic health record systems and information technology in small-to-medium sized physician offices with a vision of enhancing access to patient information, decision support, and reference data, as well as improving patient-clinician communications.
  • Surgical Care Improvement Project (SCIP). This hospital based quality improvement initiative led by CMS that focuses on reducing the rate of adverse outcomes of common surgical procedures..

History According to Zeitler (2004), Peer Review Organizations (PROs)) were established through the Peer Review Improvement Act of 1982 (a part of the Tax Equity and Fiscal Responsibility Act of 1982), replacing Professional Standards Review Organizations (PSROs) that had been established in 1972. In FY2002, they were renamed Quality Improvement Organizations (QIOs).

TAGGED:health care policyQIQ
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

a woman walking on the hallway
6 Easy Healthcare Ways to Sit Less and Move More Every Day
Health
September 9, 2025
Clinical Expertise
Healthcare at a Crossroads: Why Leadership Matters More Than Ever
Global Healthcare
September 9, 2025
travel nurse in north carolina
Balancing Speed and Scope: Choosing the Nursing Degree That Fits Your Goals
Nursing
September 1, 2025
intimacy
How to Keep Intimacy Comfortable as You Age
Relationship and Lifestyle Senior Care
September 1, 2025

You Might also Like

revenue cycle management
Global Healthcare

5 Benefits of Revenue Cycle Management (RCM) in Healthcare

August 3, 2023
eHealthMedical EthicsMedical RecordsPolicy & Law

Organization fined $418,000 for business associate HIPAA breach

May 10, 2018

Whose Diet Is Best?

May 24, 2011
healthcare data hosting
eHealthHospital AdministrationMedical RecordsTechnology

Selecting a File Transfer Solution: The Five Most Important Points Healthcare Providers Should Consider

June 30, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?