HealthCare Quality Improvement Organizations (QIO) and QIO Directory

HealthCare Quality Improvement Organizations (QIO) and QIO Directory

What are QIOs?

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 Quality Improvement Organization (QIO) contractor. 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. QIO contracts are 3 years in length, with each 3-year cycle referenced as an ordinal “SOW.”

What do QIOs do?

By law, the mission of the QIO Program is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. Based on this statutory charge, and CMS’ Program experience, CMS identifies the core functions of the QIO Program as:

  •  Improving quality of care for beneficiaries;
  • Protecting the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and necessary and that are provided in the most appropriate setting; and
  • Protecting beneficiaries by expeditiously addressing individual complaints, such as beneficiary complaints; provider-based notice appeals; violations of the Emergency Medical Treatment and Labor Act (EMTALA); and other related responsibilities as articulated in QIO-related law.

State

QIO Directory

Alabama AQAF
www.aqaf.com
Alaska Mountain-Pacific Quality Health
www.mpqhf.org
Arizona Health Services Advisory Group, Inc.
www.hsag.com
Arkansas Arkansas Foundation for Medical Care
www.afmc.org
California Health Services Advisory Group of California, Inc.
www.hsag.com
Colorado Colorado Foundation for Medical Care
www.cfmc.org
Connecticut Qualidigm
www.qualidigm.org
Delaware Quality Insights of Delaware
www.qide.org
District of Columbia Delmarva Foundation of the District of Columbia
www.dcqio.org
Florida FMQAI
www.fmqai.com
Georgia Georgia Medical Care Foundation (GMCF)
www.gmcf.org
Hawaii Mountain-Pacific Quality Health
www.mpqhf.org
Idaho Qualis Health
www.qualishealthmedicare.org
Illinois Telligen Illinois
www.telligenqio.org
Indiana Health Care Excel
www.hce.org
Iowa Telligen
www.telligenqio.org
Kansas Kansas Foundation for Medical Care, Inc.
www.kfmc.org
Kentucky Health Care Excel
www.hce.org
Louisiana eQHealth Solutions
www.louisianaqio.eqhs.org
Maine Northeast Health Care Quality Foundation
www.nhcqf.org
Maryland Delmarva Foundation for Medical Care
www.mdqio.org
Massachusetts Masspro
www.masspro.org
Michigan MPRO
www.mpro.org
Minnesota Stratis Health
www.stratishealth.org
Mississippi Information & Quality Healthcare
www.msqio.org
Missouri Primaris
www.primaris.org
Montana Mountain-Pacific Quality Health
www.mpqhf.org
Nebraska CIMRO of Nebraska
www.cimronebraska.org
Nevada HealthInsight
www.healthinsight.org
New Hampshire Northeast Health Care Quality Foundation
www.nhcqf.org
New Jersey Healthcare Quality Strategies, Inc.
www.hqsi.org
New Mexico New Mexico Medical Review Association
www.nmmra.org
New York IPRO
www.ipro.org
North Carolina The Carolinas Center for Medical Excellence
www.ccmemedicare.org
North Dakota North Dakota Health Care Review, Inc.
www.ndhcri.org
Ohio Ohio KePRO
www.ohiokepro.com
Oklahoma Oklahoma Foundation for Medical Quality
www.ofmq.com
Oregon Acumentra Health
www.acumentra.org
Pennsylvania Quality Insights of Pennsylvania
www.qipa.org
Puerto Rico Quality Improvement Professional Research Organization, Inc.
www.qipro.org
Rhode Island Quality Partners of Rhode Island
www.qualitypartnersri.org
South Carolina The Carolinas Center for Medical Excellence
www.ccmemedicare.org
South Dakota South Dakota Foundation for Medical Care
www.sdfmc.org
Tennessee QSource
www.qsource.org
Texas TMF Health Quality Institute
www.tmf.org
Utah HealthInsight
www.healthinsight.org
Vermont Northeast Health Care Quality Foundation
www.nhcqf.org
Virgin Islands Virgin Islands Medical Institute, Inc.
www.viqio.org
Virginia VHQC
www.vhqc.org
Washington Qualis Health
www.qualishealthmedicare.org
West Virginia WVMI Quality Insights
www.qiwv.org
Wisconsin MetaStar, Inc.
www.metastar.com
Wyoming Mountain-Pacific Quality Health
www.mpqhf.org

 

Source: CMS

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