Healthcare Business News

Keep QIO structure state-based, lawmakers say

By Jessica Zigmond
Posted: November 17, 2012 - 12:01 am ET

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Two members of the House Ways and Means Health Subcommittee are urging HHS to maintain a state-based structure for Quality Improvement Organization contracts as the department begins to implement QIO provisions included in a trade bill last year.

In their letter to HHS Secretary Kathleen Sebelius, Reps. Tom Price (R-Ga.) and Ron Kind (D-Wis.) outlined a host of concerns they have about the Medicare Quality Improvement program provisions that lawmakers folded into the Trade Adjustment Assistance Reauthorization bill in October 2011.

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Price, a physician, and Kind have co-sponsored legislation that would repeal the provisions of last year's bill and would ensure that QIOs keep a state-based focus. The trade bill allows these organizations to be regional or even national, which advocates such as the American Health Quality Association—which has worked with Price and Kind on their bill—have argued would compromise the working relationships QIOs have with their local communities. Price and Kind emphasized that they will still push for their bill, but they recognized that HHS must begin to implement the current law.

As the department does this, it should consider a series of factors, such as allowing QIOs to maintain a state-based structure. Other considerations include involving physicians in peer review of their states and keeping integrated functions of an QIO within one state-based organization.

“The trade bill permits a QIO's discrete functions (e.g., hospital and nursing home technical assistance, investigation of beneficiary complaints) to be broken up among different organizations instead of integrating the functions within one state-based QIO,” Price and Kind wrote in their letter. “Improving quality requires a comprehensive and integrated approach—not a fragmented one—and this is best carried out by a single, locally focused organization.”

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