Year in Numbers

In 2016, QIN-QIOs were especially successful in achieving impactful results in the areas of care coordination, diabetes care and nursing home care. BFCC-QIOs exceeded established targets for the timely review of beneficiary complaints and yielded flexible, hands-on resolutions.
The importance of outcomes: 2016 data & results

Dr. Paul McGann

Cardiac Health

QIN-QIOs work to implement evidence-based practices to improve cardiovascular health and support the Million Hearts® initiative’s goal to prevent one million heart attacks and strokes by 2022.


home health agencies (HHAs) recruited


practices recruited, representing 8,200+ clinicians


blood pressure protocols implemented by recruited practices


blood pressure protocols implemented by HHAs

Care Coordination

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


communities engaged


beneficiaries potentially affected


readmissions avoided

Diabetes Care / Everyone with Diabetes Counts

QIN-QIOs work to provide diabetes self-management education (DSME) to beneficiaries in minority diverse, rural, and impoverished communities, improve clinical outcomes, and increase adherence to clinical guidelines.


practices recruited


beneficiaries completed DSME


diabetes educators (“train-the-trainers”) trained by QIN-QIOs


languages in which DSME classes were taught, including English, Spanish, French, Russian, Mandarin, Cantonese, Korean, Vietnamese, Swahili, Hmong and Tagalog

Health Care-Associated Infections

QIN-QIOs focus on patient-centered, comprehensive HAI reduction targeting central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), Clostridium difficile (C. diff) infections, and ventilator-associated events (VAEs).


hospitals recruited**


CLABSI infections avoided,
a 16.7% reduction**


C. diff infections avoided,
a 1.5% reduction**


QIN-QIOs work to improve immunization rates among minority and underserved populations in 37 states and territories nationwide (based on greatest need), helping increase their rates of influenza, pneumonia and herpes zoster vaccinations.


facilities recruited


home health agencies (HHAs) recruited


practices recruited, representing 7,000+ clinicians


pharmacies recruited


recruited Medicare beneficiaries impacted through education/outreach


pneumonia and flu immunizations administered by recruited clinicians and practices

Medication Safety

QIN-QIOs work to improve medication safety and to reduce or prevent adverse drug events via improvement processes and education on proper medication use and patient engagement.


beneficiaries at high risk for an adverse drug event (ADE) were screened for ADE


medication errors were identified for opportunities of harm avoidance (potential ADEs)*


facilities, clinicians and practices are working with QIN-QIOs on improving medication safety and preventing adverse drug events

Nursing Home Care

Through the National Nursing Home Quality Care Collaborative, QIN-QIOs seek to ensure that every nursing home resident has the highest quality of care.


nursing homes recruited (more than 74% of all nursing homes in the U.S.)


reduction in antipsychotic medication use in nursing homes across the nation

Quality Reporting / Quality Payment Program

Building on their experience assisting providers with electronic health record use, value-based payment programs, and Physician Quality Reporting System (PQRS) reporting, QIN-QIOs now serve as a Quality Payment Program technical assistance resource for groups of 16 or more eligible clinicians. QIN-QIOs will help eligible clinicians to easily comply with their Quality Payment Program reporting requirements and to smoothly transition into Alternative Payment Models (APMs). QIN-QIOs will utilize a service-oriented approach when providing technical assistance, education and outreach, and LAN activities. The QIN-QIOs’ technical assistance includes, but is not limited to: reporting and submission support, leveraging the use of Certified Electronic Health Record Technology, selecting quality measures, and identification of resources.

QIN-QIOs help providers use health IT to decrease paperwork, improve access to medical records, and facilitate care coordination.


hospitals recruited**


clinicians recruited**

QIN-QIOs support the ability of hospitals and clinicians to report quality data to CMS. They also help providers use this data to drive improvement.


practices, representing 26,300+ clinicians, received direct technical assistance related to PQRS measure improvements from QIN-QIOs**


practices received communication and education about value modifier (VM) and PQRS**


hospitals received technical assistance regarding outpatient quality improvement


hospitals received technical assistance regarding inpatient quality improvement


other facilities (ambulatory surgical centers, inpatient psychiatric facilities, Prospective Payment System-Exempt Cancer Hospitals, and critical access hospitals) received technical assistance

Behavioral Health

Six regional QIN-QIOs provide technical assistance and educational interventions to help primary care providers screen for and increase the identification of people with depression or alcohol use disorder. In addition, QIN-QIOs work with inpatient psychiatric facilities to improve transitions of care and reduce readmissions for these and other patients after discharge.


practices recruited**


inpatient psychiatric facilities (IPFs) recruited**


reduction in IPF readmissions


The Transforming Clinical Practice Initiative (TCPI) is preparing 140,000 clinicians for successful participation in Alternative Payment Models like Accountable Care Organizations and bundled payment programs. QIN-QIOs partner with the Practice Transformation Networks in their region to assess the progress of participating practices through the five phases of practice transformation. The QIN-QIOs assess progress by conducting baseline and ongoing assessments.


baseline assessments completed


follow-up assessments completed

Numbers are based on the most recent data sources available to the Quality Innovation Network National Coordinating Center as of January 31, 2017, unless otherwise noted.  

*Potential ADEs (pADEs) are reported by QIOs quarterly, and an individual beneficiary may have multiple pADEs per quarter.
**Data reported through July 2016.


Sally Berko and Angel Davis

Accomplishments to Date


Cost savings achieved through Higher Weighted Diagnosis-Related Group (HWDRG) reviews


Total Case
Review Volume

Graph depicting change in case review volume per year, from approximately 6,000 case reviews in August 2014 to approximately 16,000 in January 2017.

BFCC-QIOs conducted more than 29,050 reviews for quality of care concerns, and identified more than 3,850 opportunities for quality improvement across a variety of health service providers. The primary quality of care concern, representing16% of concerns identified, was not establishing an appropriate treatment plan. More than 328,800 discharge appeal reviews were completed, resulting in more than 68,200 beneficiaries not being discharged earlier than necessary.

BFCC-QIOs worked in partnership with QIN-QIOs to perform and report more than730 successful Quality Improvement Initiatives (QIIs) that improve health care quality by assisting providers and/or practitioners to identify the root cause of a concern, develop a framework in which to address the concern, and improve a process or system.

Help spread the word!