QIO Program Fact Sheets

In August 2014, the Centers for Medicare & Medicaid Services (CMS) established a new functional structure for the Quality Improvement Organization (QIO) Program that delivers program value to Medicare beneficiaries and their families, maximizes learning and collaboration for improving care, and supports the spread and sustainment of effective new practices and models of care. The Program separated the review of Medicare beneficiary quality of care concerns and appeals from quality improvement work carried out in provider and community settings. Two Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIOs), covering all 50 states and three territories, address quality of care concerns and appeals, while 14 Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) work with providers, stakeholders, and Medicare beneficiaries to improve the quality of health care for people with targeted health conditions.

These fact sheets provide information about the QIO Program and its alignment with the National Quality Strategy to provide safe and affordable health care to the entire U.S. population in every community.
 

Image of doctors sitting at tableQuality Innovation Network-Quality Improvement Organizations

QIN-QIOs help patients and families, providers, and communities make care safer, support active engagement and self-management of chronic conditions, eliminate health disparities, promote best practices for healthy living, deliver improved access to care, and make care affordable. 

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Image of older African-American female doctorBeneficiary and Family Centered Care-Quality Improvement Organizations

BFCC-QIOs address all beneficiary concerns and appeals, quality of care reviews, cases of suspected “patient dumping” covered by the Emergency Medical Treatment and Labor Act (EMTALA), and other types of case reviews. The two BFCC-QIOs, Livanta and KEPRO, serve all 50 states and three territories.

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Image of older African-American coupleImproving the Health Status of Communities

QIN-QIOs assist patients and families, providers, and communities to eliminate health disparities, promote best practices for healthy living and deliver improved access to care.

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Image of doctor washing his handsSafe Care that is Person- and Family-Centered, Reliable and Accessible

QIN-QIOs assist patients and families, providers and communities in order to provider safer care.

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Image of older African-American female doctorCoordinating Better Care & Lowering Costs

QIN-QIOs assist patients and families, providers, and communities to improve care coordination and make care affordable.

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