The June 29 Modern Healthcare article Report cites cherry-picking by QIOs unfairly characterizes the methods used by quality-improvement organizations to help nursing homes improve. QIOs did not cherry-pick nursing homes. For their first partnerships with nursing homes, they followed guidance suggesting they focus on average performers, which exhibit a wide range of performance levels. Accordingly, QIOs generally avoided both top performers and low performers in their first three years of working with nursing homesthe period covered by the GAO study.
Starting in late 2005, every QIO began working with a small number of low-performing nursing homes, and as stated in your article, the QIO community supports expansion of that important assignment if funding can be found.
The statement that CMS should require the QIOs to give up the identities of the facilities they are working with is incorrect. It is not CMS or the QIOs that make the determination of what information can be shared; it is public law. In this instance, the decision that QIOs were prohibited from sharing this information with CMS was made in 2005 by the Health and Human Services Office of General Counsel. The inability to share this information actually puts QIOs at a disadvantage because it impedes CMS ability to fully evaluate their impact in this area.
David SchulkeExecutive vice presidentAmerican Health Quality Association
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