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
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    benefits of using protein powder to build muscles
    Protein Powder for Muscle Mass: Everything You Need to Know
    December 12, 2021
    changes brought on by blockchain in healthcare
    Technology In The Healthcare Industry
    March 28, 2022
    What Does Core Body Temperature Say About Health?
    August 17, 2022
    Latest News
    Health Benefits of Taking a Vacation to Reduce Your Stress
    September 27, 2023
    First Aid Training Enhancing Workplace Health and Safety
    September 25, 2023
    Beyond the Clinic: Medical Surveys Are a Roadmap to Passive Income for Doctors
    September 23, 2023
    5 Self-Care Habits to Help You Live an A+ Life
    September 21, 2023
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    medical malpractice
    Losing a Loved One Due to Medical Malpractice: All You Need to Know
    August 9, 2022
    Platelet-Rich Plasma Therapy: Much Ado about Nothing?
    August 26, 2017
    1.1 Million Elderly Taken to ED for Adverse Medication Reactions
    April 18, 2011
    Latest News
    Job Seekers with Disabilities Should at Health Insurance Benefits
    September 12, 2023
    Reasons That Drug Prices Are Rising to Unsustainable Levels
    September 12, 2023
    How Revenue Lifecycle Management Helps Healthcare Providers to Optimize Business Operations
    September 6, 2023
    The Hidden Benefits of Practice Exams for Medical Professionals
    September 6, 2023
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: What are QIOs?
Share
Sign In
Notification Show More
Aa
Health Works CollectiveHealth Works Collective
Aa
Search
Have an existing account? Sign In
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > What are QIOs?
BusinessPolicy & Law

What are QIOs?

JasonShafrin
Last updated: 2017/09/09 at 9:35 PM
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 policy, QIQ

Sign Up For Daily Newsletter

Be keep up! Get the latest breaking news delivered straight to your inbox.
By signing up, you agree to our Terms of Use and acknowledge the data practices in our Privacy Policy. You may unsubscribe at any time.
JasonShafrin March 29, 2011
Share This Article
Facebook Twitter Copy Link Print
Share
Previous Article Spreading the Health Care Cost Pain to the Elderly
Next Article How Increasing Medicare Age of Eligibility Saves Under Reform

Stay Connected

1.5k Followers Like
4.5k Followers Follow
2.8k Followers Pin
136k Subscribers Subscribe

Latest News

Andropause hormonal decline
The Benefits of TRT for Andropause and Hormonal Decline
Wellness September 28, 2023
Cancer Prevention
The Importance of Lipoma Examination in Cancer Prevention
Cancer September 28, 2023
dental implant
Cost Analysis of Dental Implants in Australia
Dental health September 28, 2023
View,Of,Niagara,Falls,In,Autumn
Health Benefits of Taking a Vacation to Reduce Your Stress
Health September 27, 2023

You Might also Like

health insurance disability
Policy & Law

Job Seekers with Disabilities Should at Health Insurance Benefits

September 12, 2023
medical billing training
Medicare

Navigating Through the Essentials: Medical Billing Training for Beginners

September 12, 2023
rising drug costs
Pharmaceuticals

Reasons That Drug Prices Are Rising to Unsustainable Levels

September 8, 2023
healthcare providers
Hospital Administration

How Revenue Lifecycle Management Helps Healthcare Providers to Optimize Business Operations

September 6, 2023
Subscribe

Subscribe to our newsletter to get our newest articles instantly!

Follow US
© 2008-2023 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Lost your password?