Revision to Medicare QIO's

For years, state QIO's have had a strained relationship with the physician groups they've been asked to regulate (or help).

In a recent report from the Institute of Medicine (IOM) under contract from HHS, a new day may be dawning for state QIO's.

Historically, QIO's have performed a number of functions including review of complaints from Medicare beneficiaries, promoting health care quality, assurance that hospitals/doctors meet essential quality standards, and the like. Yet, at the core, most provider organizations haven't experienced QIO's as the one's to turn to for genuine help in measuring and improving quality.

In a new role, QIO's could become a source of technical assistance to health care organizations and practitioners. With an anticipated surge in pay for performance contracts (private and public) and increasing demand to report outcome measures as part of the transparency movement, QIO's may be in a position to actually help practitioners (particularly smaller groups).

And now for the punch line...the regulatory limb of the QIO's would have to be moved to another party (hence the conflicting responsibilities removed).

What's in it for QIO's? Well, for starters, QIO contracts would be open to bid for minimum of 5 year terms. Groups like the Iowa Foundation for Medical Care and MetaStar(QIOs well know true quality approaches) would likely be quite successful in an open bid process to the betterment of several state QIO programs.

Looking ahead, we're optimistic!