The CMS announced changes to its contract with Medicare's quality improvement organizations that it said will improve oversight of the regional quality groups and better track progress in healthcare facilities safety initiatives.
The new three-year contract, or statement of work, will begin Aug. 1 and focuses on performance measures, requiring QIOs to meet goals if they want to receive financial incentives and future contracts from the CMS, which released details of the changes to the statement of work during a news conference.
Through the new statement of work, QIOs must work with a variety of healthcare facilities to improve quality and performance in four key areas: protecting beneficiaries, care transitions, patient safety and prevention. The CMS will use nationally endorsed measurements, available on its hospital comparison Web site to monitor the QIOs' progress.
QIOs will have to work closely with providers to encourage the use of electronic health records especially to track immunizations and cancer screening, and will use data from case reviews to determine problems in quality of care.
Acting CMS Administrator Kerry Weems said the changes are in response to reports by the Institute of Medicine and the Government Accountability Office that criticized Medicare's management of the QIOs.
Under the new contract, QIOs will be expected to reach performance milestones throughout the three years, instead of facing one review at the end of the contract. At 18 months, the CMS will have the option to redirect the contract to another organization if a QIO has not proved it has made progress in its region. Not hitting additional milestones could also impact a QIO's ability to compete for future contracts of work, said Barry Straube, chief medical officer for the CMS, during the conference.