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What We Do

Background / Overview

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."

One of our primary statutory missions is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries.

We strive to do this with focus on the following: 

  • Beneficiary and Family Centered Care
  • Improving Individual Patient Care
  • Integrating Care for Populations and Communities  
  • Improving Health for Populations and Communities  

Drivers 

  • Supporting and Convening Learning and Action Networks
  • Providing Technical Assistance
  • Care Reinvention through Innovation Spread

Success Stories

Section for success stories