CMS Begins Restructuring Of Quality Improvement Program

May 16, 2014 | Uncategorized

shutterstock_113445967The Centers for Medicare & Medicaid Services (CMS) has taken its first step toward improving its efforts to ensure the effectiveness, efficiency, economy, and quality of care quality for Medicare beneficiaries in through the Quality Improvement Organization (QIO) Program.nnLast week, the federal agency announced the selection of Livanta LLC and KePRO as Beneficiary and Family Centered Care (BFCC) would be responsible for the program’s case review and monitoring activities at a broader level than the traditional QIO activities taking place at a more local level.nnBetween them, the two BFCC QIOs will oversee five geographic areas — Livanta (Areas 1, 5), KePRO (Areas, 2–3) — of the United States and its territories:n

Area 1: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Puerto Rico, Rhode Island, Vermont, Virgin IslandsnArea 2: District of Columbia, Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West VirginianArea 3: Alabama, Arkansas, Colorado, Kentucky, Louisiana, Mississippi, Montana, North Dakota, New Mexico, Oklahoma, South Dakota, Tennessee, Texas, Utah, WyomingnArea 4: Iowa, Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, WisconsinnArea 5: Alaska, Arizona, California, Hawaii, Idaho, Nevada, Oregon, Washington

nEstablished by statute in 1982, the Medicare Quality Improvement Program Program is currently in its earliest phase of transformation which CMS set in motion back in 2011 with the publishing of the 10th Statement of Work (SOW).nn“One of the most critical roles of CMS is to protect the quality and safety of care delivered to beneficiaries. Care needs to be patient-centered and directly engage patients, families, and caregivers,” Dr. Patrick Conway, Deputy Administrator for Innovation and Quality and CMS CMO, said in a public statement. “The quality of care review is essential to ensure care delivered to all beneficiaries meets professionally recognized standards.”n

nnThe next step for improving the QIO Program is expect to take place this July with the award of contracts to organizations responsible for working directly with providers and communities. Shortly thereafter, CMS will release its 11th SOW on August 1.n


Source:; Kyle Murphy; May 13, 2014.