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QUALITY IMPROVEMENT ORGANIZATIONS

The Remaking American Medicine campaign worked closely with the nation's Quality Improvement Organizations (QIOs). Operating under specific contracts from the Centers for Medicare & Medicaid Services (CMS), QIOs work with consumers, physicians, hospitals, and other caregivers to refine care delivery systems to make sure Medicare beneficiaries receive quality care. This may include nursing home and home health care providers, as well as hospitals and physicians' offices. QIOs are also dedicated to finding methods that reduce disparities in treatment for Medicare recipients from underserved populations or living in rural communities. Every state and US territory or possession is served by a QIO. They have been working for more than two decades with CMS to ensure quality health care for beneficiaries.

Many QIOs spearheaded the development of local/regional coalitions in their communities. Working closely with their health care colleagues and reaching out to PBS stations, QIOs viewed their participation in Remaking American Medicine as an opportunity to advance their own ongoing missions to improve health care quality. You can use the Connect with Others searchable database to identify if your state's QIO.

QIO Resources:

MedQIC is a web-based resource for the national network of QIOs funded by CMS. Statebased QIOs provide resources for practice innovations in health care delivery to providers in the United States, its territories, and the District of Columbia.

QIO's by state:

            Alabama

 

AQAF - AQAF works with health care professionals, organizations, government, business, and consumers to improve the delivery of quality, appropriate, timely and cost effective health care services to all patients. AQAF serves to improve the quality of health care by promoting cooperation with physicians and providers, by monitoring and interpreting patterns of health care and sharing the resulting information.

Alaska - Mountain-Pacific Quality Health (see Montana)

Arizona

Health Services Advisory Group - For 25 years, the Health Services Advisory Group (HSAG) has provided innovative leadership on health care quality improvement projects for Federal, state and private sector clients. Founded by a group of medical professionals in 1979, HSAG is one of most experienced quality improvement organizations in the nation. HSAG is recognized as an agent of change in the industry because of the company's successful collaboration with providers across the continuum of care. Vist HSAG's Remaking American Medicine Web page.

Arkansas

Arkansas Foundation for Medical Care - The Arkansas Foundation for Medical Care (AFMC) is a nonprofit corporation dedicated to the clinical evaluation and improvement of health care in Arkansas. AFMC provides in-depth quality evaluation and improvement programs for Medicare, Medicaid and other payors; offers a variety of data management services to both the public and private sectors; and conducts extensive patient and public health education activities.

California

Lumetra - Lumetra is a nonprofit, health information organization charged with improving the quality of care received by California's 4.1 million Medicare beneficiaries. Based in San Francisco, Lumetra works with providers, consumers and purchasers to improve the quality, safety, and integrity of health care through review, analysis, information dissemination, and consultation.

Colorado

Colorado Foundation for Medical Care - The Colorado Foundation for Medical Care (CFMC) works collaboratively with the Medicare and Medicaid programs, as well as health providers and managed care companies, to improve the quality of health care and assure appropriate utilization.  Vist CFMC's Remaking American Medicine Web page.

Connecticut

Qualidigm - Qualidigm is the Quality Improvement Organization (QIO) for Connecticut. Our mission is to improve people's health through education, research, and services that improve the delivery of health care. Qualidigm promotes our vision of healthy people and outstanding delivery through a variety of consumer and professional educational activities, quality improvement interventions, research and collaborations with other health care professionals.

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Delaware

Quality Insights of Delaware - Quality Insights of Delaware, an affiliate of the West Virginia Medical Institute (WVMI), is dedicated to improving the health of the people we serve. Quality Insights was established in 1999 to help Delawareans "Take Good Care." We collaborate with both professionals and consumers in our work to improve health care quality.

District of Columbia - Delmarva Foundation (see Maryland)

Florida


FMQAI - A subsidiary of Health Service Advisory Group, FMQAI, is Florida's Medicare Quality Improvement Organization (QIO) and the End Stage Renal Disease (ESRD) Network of Florida. FMQAI implements projects focused on improving the care provided to Medicare beneficiaries. FMQAI's mission is to ensure the quality, effectiveness, efficiency, and economy of health care services provided to Medicare beneficiaries. FMQAI is responsible for improving beneficiary safety and health by completing specific tasks.

* Visit FMQAI's Remaking American Medicine Web page.

Georgia

gmcf - Responsiveness is one of the cornerstones of gmcf's approach to its work. In an ever changing health care environment, we do more than keep pace with the increasing needs of our customers: we anticipate and adjust to new challenges. Our flexibility is demonstrated in the wide range of health care related services we provide that include the Medicare Quality Improvement Initiatives in Georgia. In a wide array of health care activities that span more than 30 years, gmcf has a membership of over 1,700 actively practicing Georgia physicians, located throughout the state, who represent all specialties and all settings.

Hawaii - Mountain-Pacific Quality Health (see Montana)

Idaho - Qualis Health (see Washington)

Illinois

Illinois Foundation for Quality Health Care - The Illinois Foundation for Quality Health Care (IFQHC) optimizes the quality of medical care and health by supporting and encouraging continuous improvement in provider practice, consumer education, and community outreach for the state of Illinois; through the sharing of knowledge, technology, skills, and resources.

Indiana

Health Care Excel - HCE's primary objective is to produce products that will improve health care in a cost-contained environment. The organization has a long tradition of Medicare and Medicaid medical peer review. For over a quarter century, Health Care Excel (HCE) has objectively evaluated health-care quality, clinical appropriateness, and outcome assessments. The company designs customized management solutions and develops appropriate educational programs to significantly improve the delivery of health services.

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Iowa

Iowa Foundation for Medical Care - The Iowa Foundation for Medical Care (IFMC) is the Medicare Quality Improvement Organization (QIO) for Iowa. QIOs work with physicians and health care professionals to promote high quality medical care for Medicare consumers. IFMC is contracted by the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services.

Kansas

Kansas Foundation for Medical Care - The Kansas Foundation for Medical Care's mission is to facilitate the improvement of health care. Our vision is to serve as the primary agent in focusing the statewide health care community to achieve significant and continuing improvement in the quality of health care. In this role, we will encourage the active involvement of the health care community. We strive to be both a partner and a resource to the health care community in our joint efforts to improve the health care provided to our citizens.

Kentucky - Health Care Excel (see Indiana)

Louisiana

Louisiana Health Care Review - LHCR is a leader in the health care quality improvement arena, having served as Louisiana's Quality Improvement Organization for the last 16 years. LHCR works under contract with the Centers for Medicare & Medicaid Services (CMS) - the federal agency that administers Medicare. LHCR partners with hospitals, physicians, other health care providers and community organizations to improve the quality of health care for Louisiana's nearly 630,000 Medicare beneficiaries.

Maine

Northeast Health Care Quality Foundation - The Northeast Health Care Quality Foundation (NHCQF) contracts with the Centers for Medicare & Medicaid Services (CMS) to serve as the Medicare Quality Improvement Organization (QIO) for the states of Maine, New Hampshire, and Vermont. NHCQF also contracts with the New Hampshire Department of Health and Human Services to review hospital and managed care services and to conduct quality improvement projects for the Medicaid population.

Maryland


Delmarva Foundation - Delmarva Foundation is a national, not-for-profit organization dedicated to improving health care quality in over 20 states. Since 1973, Delmarva has assisted in enhancing care in hospitals, nursing homes, home health agencies, and doctors' offices and managed care plans. Delmarva conducts work ranging from quality improvement, quality assurance, and utilization review to external quality review. The company's corporate headquarters are located in Easton, Maryland with other offices in Baltimore, Maryland; Washington, DC, Florida; and Tampa and Tallahassee, Florida.

Massachusetts

MassPRO - The Massachusetts Quality Improvement Organization (MassPRO) has been making a difference in the lives of patients and families since its creation in 1985. For over 18 years, MassPRO has been an independent, objective voice for improving health care in Massachusetts. We maintain a highly skilled staff of physicians, nurses, PhDs, data analysts, information technology professionals, change agents, quality improvement leaders, communications experts, meeting planners, writers, educators, researchers, case reviewers and problem-solvers.

Michigan

MPRO - Michigan's Health Care Quality Improvement Organization, strives to improve the quality of health care and has many projects and services to assist Medicare and Medicaid beneficiaries and health care professionals. In addition MPRO also provides services for state agencies in Michigan, Minnesota, Indiana, Wisconsin, Vermont, and to TRICARE beneficiaries in 23 states.

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Minnesota

Stratis Health - Stratis Health is a nonprofit independent quality improvement organization that collaborates with providers and consumers to improve health care. We have served in Minnesota as the Medicare Quality Improvement Organization (QIO) for many of the more than 30 years of our existence. Our objectives are to help health care providers understand and integrate quality improvement and safety into their work, and to support Medicare consumers in their quest for health education and quality information.


Mississippi


Information and Quality Healthcare - Information and Quality Healthcare (IQH) is a nonprofit corporation chartered in 1971 in Mississippi. IQH serves as the federally designated quality improvement organization for Mississippi under contract to the Centers for Medicare & Medicaid Services (CMS). IQH seeks to fulfill its vision to be a leader in promoting a quality and cost-effective health care system.

Missouri

Primaris - Primaris is a nonprofit health care consulting firm that works together with the health care community on performance improvement strategies, medical records review, provider and patient education, data collection and analysis and organizational development. Our mission is to improve health care delivery and outcomes by promoting excellence, advancing knowledge, and developing innovative solutions for the health care community, government, business and consumers. Primaris is a growing and diverse organization with a more than 20-year record of providing excellent consultation.

Montana


Mountain-Pacific Quality Health - Mountain-Pacific Quality Health is the quality improvement organization (QIO) for Montana, Wyoming, Hawaii, Alaska and the territories of Guam, the Commonwealth of the Northern Marianas and American Samoa. The Foundation operates out of offices in Helena, Montana; Cheyenne, Wyoming; Honolulu, Hawaii and Anchorage, Alaska.

Nebraska


CIMRO of Nebraska - CIMRO-NE staff assists health care providers in improving the quality of health care delivered to Medicare beneficiaries in Nebraska. CIMRO-NE works to promote quality health care services, determines medical necessity of services rendered, and ensures professionally recognized standards of care are met for services rendered.

Nevada

HealthInsight - HealthInsight is a private, nonprofit organization dedicated to improving the health care systems of Utah and Nevada. Our goal is to become the recognized leader of health care quality improvement in our communities.

New Hampshire - Northeast Health Care Quality Foundation (see Maine)

 

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New Jersey


Healthcare Quality Strategies - Healthcare Quality Strategies, Inc. (HQSI), is an independent nonprofit company that performs health care quality studies and conducts medical record reviews for federal, state and private agencies. Founded in 1982, HQSI, formerly PRONJ, has completed more than 50 health-related quality improvement projects.

New Mexico


New Mexico Medical Review Association - The New Mexico Medical Review Association (NMMRA) mission is to improve the quality and protect the integrity of health care in New Mexico. NMMRA is New Mexico's not-for-profit, physician-sponsored and federally contracted Medicare Quality Improvement Organization (QIO). The organization works with physicians, hospitals, nursing homes, home health agencies, other health care providers and Medicare beneficiaries to improve the quality of health care in New Mexico. Vist NMMRA's Remaking American Medicine Web page.

New York

IPRO - IPRO's mission is to improve the quality of health care services provided to Medicare beneficiaries across the State of New York. We do this by partnering with professional, medical specialty and advocacy organizations at the statewide and regional level, as well as by collaborating with individual hospitals, nursing homes, home health agencies, health plans, and health care professionals. Vist IPRO's Remaking American Medicine Web pages for Consumers and Providers.

North Carolina

The Carolinas Center for Medical Excellence - North Carolina - The Carolinas Center for Medical Excellence, formerly Medical Review of North Carolina (MRNC), is a nonprofit, physician-sponsored health care consulting firm and the Medicare Quality Improvement Organization (QIO) for North Carolina.

North Dakota


North Dakota Health Care Review, Inc. - North Dakota Health Care Review, Inc. (NDHCRI), a private, nonprofit organization, brings together a unique team of professionals trained in medicine, data base management, data analysis, process evaluation, coding and utilization review, health education, and communications. By combining these skills, the NDHCRI team is able to work collaboratively with health care providers and consumers, offering a wide range of resources and improvement opportunities to the North Dakota health care community.

Ohio


Ohio KePRO - Ohio KePRO is the Medicare Quality Improvement Organization (QIO) for Ohio, under contract with the Centers for Medicare & Medicaid Services (CMS). We are committed to excellence in customer service and continuous quality improvement in health care through the provision of innovative products and services for providers and beneficiaries

Oklahoma

Oklahoma Foundation for Medical Quality - For more than 30 years, the Oklahoma Foundation for Medical Quality (OFMQ) has worked to safeguard quality health care in Oklahoma. We not only identify opportunities to help improve care, we help to implement programs that affect the quality of care patients receive. OFMQ works with every sector of the health care system, including hospitals, physicians, managed care organizations, nursing homes, home health agencies and other medical professionals and consumers.

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Oregon

Acumentra Health - Since 1984, Acumentra Health, a private nonprofit organization, has worked to improve the quality and effectiveness of health care. Acumentra Health collaborates with practitioners, providers, public agencies, and private organizations on a wide range of health care improvement projects and programs. This work spans the continuum of care, reaching all age and economic levels, and all delivery systems.

Pennsylvania

Quality Insights of Pennsylvania - The goal of Quality Insights of Pennsylvania is to be a partner and a resource for physicians, hospitals, nursing homes, home health agencies, Medicare Advantage plans, and community and advocacy organizations. Our staff of more than 60 health care professionals, data analysts, and communications professionals are located in three offices throughout the Commonwealth – in Harrisburg, Pittsburgh, and Wayne – to better meet the needs of Pennsylvania health care providers.


Puerto Rico


Quality Improvement Professional Research Organization - QIPRO is under contract with the Centers for Medicare and Medicaid Services for the implementation of the Medicare Quality Improvement Program in Puerto Rico. Its unique importance comes from the fact that is the only organization with the mission of evaluating the quality of health care services rendered to Medicare beneficiaries.

Rhode Island

Quality Partners of Rhode Island - Quality Partners of Rhode Island is a nationally recognized leader in healthcare quality improvement. We provide healthcare professionals with tools, consultation, and reliable information to improve the quality of their services. Quality Partners also encourages consumers to work with their healthcare providers to be as healthy as possible.


South Carolina


The Carolinas Center for Medical Excellence - South Carolina - The Carolinas Center for Medical Excellence, formerly known as Carolina Medical Review, is a nonprofit, physician-sponsored, and the Medicare Quality Improvement Organization (QIO) for South Carolina. We have a highly qualified staff of physicians, nurses, epidemiologists, biostatisticians, health information management, communications, and administrative personnel.

South Dakota


South Dakota Foundation for Medical Care - South Dakota Foundation for Medical Care (SDFMC) is the physician Peer Review Organization (PRO) and a Quality Improvement Organization (QIO) for the Medicare program in South Dakota. SDFMC has worked to improve the quality of health care since 1973. In this role, SDFMC serves as a quality improvement facilitator and resource to health care professionals, offering experience in project development, design and implementation. SDFMC's primary areas of service are quality improvement and medical review.

Tennessee


QSource - The QSource mission is to improve the quality of health care through education and advocacy. QSource Center for Healthcare Quality, formerly known as Mid-South Foundation for Medical Care, Inc. is an independent not-for-profit federally approved organization. QSource is the CMS-designated Quality Improvement Organization (QIO) for the state of Tennessee.


Texas


TMF Health Quality Institute - TMF is a private, nonprofit organization of licensed physicians (MDs and DOs) founded in the early 1970s with the support of the Texas Medical Association and Texas Osteopathic Medical Association. TMF was chartered as an independent organization to promote, develop, define and encourage the delivery of high quality medical care and health services to Texas.

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Utah - HealthInsight (see Nevada)

 

Vermont - Northeast Health Care Quality Foundation (see Maine)

 

Virgin Islands


Virgin Islands Medical Institute Inc. - The Virgin Islands Medical Institute, Inc. (VIMI) is a nonprofit quality improvement organization that works with all aspects of the health care system (hospitals, nursing homes, home health agencies, providers, physicians and consumers) in the United States Virgin Islands to resolve problems, correct deficiencies, and improve the performance and quality of health care.

Virginia


Virginia Health Quality Center - The Virginia Health Quality Center (VHQC) is a health care quality improvement organization that offers services to a wide range of clients who are interested in assessing and improving the quality of health care for a variety of populations. Established in 1984, the VHQC partners with Virginia's health care community to improve patient care for Virginia's 913,886 Medicare beneficiaries in all health care settings, including hospitals, physician offices, nursing homes and home health agencies.

Washington

Qualis Health - Qualis Health is a private, nonprofit organization that offers programs and services to generate, apply and disseminate knowledge to improve the quality of health care delivery and health outcomes. In operation since 1974, the firm has headquarters in Seattle, with offices in Boise, Idaho and Anchorage, Alaska.

West Virginia

West Virginia Medical Institute - The West Virginia Medical Institute (WVMI) is a nonprofit, physician-sponsored organization dedicated to improving the health of the people we serve. WVMI operates two affiliate corporations, Quality Insights of Delaware (QID) and Quality Insights of Pennsylvania (QIP), which serve their respective states. WVMI's is the quality improvement organization in West Virginia, Delaware and Pennsylvania

Wisconsin


MetaStar, Inc. - MetaStar's mission is to effect positive change in the quality, efficiency and effectiveness of health care. For over 30 years, MetaStar has been assuring cost-effective, quality health care based on extensive knowledge and experience in the areas of quality improvement, data analysis, and cost containment.

Wyoming - Mountain-Pacific Quality Health (see Montana)


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