Introduction

Dennis Wagner & Jeneen Iwugo

An introduction from Dennis Wagner, Director, and Jeneen Iwugo, Deputy Director, Quality
Improvement and Innovation Group (QIIG), Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services (CMS).

QIO Program Structure

How We Serve Medicare Beneficiaries

A graphic of a roman temple showing the structure of the QIO program

The Quality Improvement Organization (QIO) Program structure follows a functional model with two types of QIOs: Quality Innovation Network-QIOs (QIN-QIOs) and Beneficiary and Family Centered Care-QIOs (BFCC-QIOs). Fourteen regional QIN-QIOs work with providers, community partners and beneficiaries on multiple data-driven quality improvement initiatives to improve patient safety, reduce harm, engage patients and families, improve clinical care and reduce health care disparities. Two BFCC-QIOs manage all beneficiary complaints and appeals across the nation, ensuring that beneficiaries are treated fairly and helping them exercise their right to high-quality health care. 

Qio Program

Year In Numbers

QIN-QIOs

Care Coordination:
QIN-QIOs help providers and communities reduce avoidable hospital admissions and readmissions by improving the quality of care transitions.

350+
communities engaged
23M+
beneficiaries
potentially affected
24,350+
readmissions avoided

BFCC-QIOs

In their second year of providing medical record reviews and Immediate Advocacy for Medicare beneficiaries, BFCC-QIOs nearly doubled the cost savings achieved.

448,200+
Total Review volume
$20M
Cost savings achieved through Higher Weighted DRG reviews
Qio Program

Year In Review

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Strategic Innovation Engine Gathers Innovative Practices

The QIO Program’s Strategic Innovation Engine (SIE) kicked off its initiative to gather and spread innovative practices in June, reaching...

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Hospital Improvement Innovation Network (HIIN) Contract Awards

In September 2016, the Centers for Medicare & Medicaid Services (CMS) awarded $347 million to 16 national, regional or state hospital...

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Samuel J. Heyman Service to America Honor

CMS leaders accepted the Samuel J. Heyman Service to America Medal (SAMMIE) for Federal Employees of the Year. The award was made...

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Special Innovation Projects Awards

In October 2016, CMS awarded 20, two-year Special Innovation Projects (SIPs) to 12 QIN-QIOs. The SIPs are quality improvement projects...

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Indian Health Service Contract Award

CMS awarded a contract in September 2016 to HealthInsight – the QIN-QIO serving Nevada, New Mexico, Oregon and Utah – to assist Indian...

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CMS Establishment of Quality Payment Program

CMS formally established the Quality Payment Program in October 2016 and launched a user-friendly website to help stakeholders understan...

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Qio Program

Snapshots of Success

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BFCC-QIO and QIN-QIO Collaboration

Alliant Quality QIN-QIO and KEPRO BFCC-QIO Partner to Reduce Adverse Drug Events
Read More
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Cardiac Health

TMF QIN-QIO and Partners Improve Access to Blood Pressure Monitoring and Management Tools
Read More
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Behavioral Health

HealthInsight QIN-QIO Collaborates with Primary Care Providers and Partners to Increase Behavioral Health Screenings Across Four States
Read More
View all stories
2016 CMS Quality Conference

Highlights

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Key Announcements

View important results and goals announced during the daily plenaries.

Cara James, Director, CMS Office of Minority Health

Daily Recap Videos

Watch the highlight reel for major conference themes and takeaways.

Vikki Wachino, Former Director, Center for Medicaid and CHIP Services and Deputy Administrator, CMS

Conference Photos

Take a look back at each day of the conference through the Flickr photo albums.

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Spotlight on Social Media

See the buzz generated among the health care community.

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Help spread the word!