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Medical Writings |18 March 2008

Medicare's Quality Improvement Organization Program: Maximizing Potential

Fred J. Hellinger, PhD

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Author, Article, and Disclosure Information

Structured abstracts of information on newly published books, computer programs, selected Web sites, and other material are provided in this portion of Medical Writings.

Structured abstracts of information on newly published books, computer programs, selected Web sites, and other material are provided in this portion of Medical Writings.

  • From the Agency for Healthcare Research and Quality, Rockville, Maryland.
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U.S. Institute of Medicine. 518 pages. Washington, DC: National Academies Pr; 2006. $59.95. ISBN 0309101085. Order at http://www.nap.edu.
Field of medicine: Health care management.
Format: Hardcover book.
Audience: Health care providers, legislative and executive branch staff, quality improvement organizations (QIOs), Medicare beneficiaries, and stakeholder groups.
Purpose: This book was written in response to a Congressional request in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 for the Institute of Medicine to conduct an evaluation of the QIO program administered by the Centers for Medicare & Medicaid Services and to recommend how to restructure the program to spur more rapid improvement in health care quality.
Content: This book traces the development of Medicare's quality assurance activities over the past 35 years with a focus on the past 5 years. It is highly informative, comprehensive, and thorough. The authors' primary conclusion is that “it is not possible to determine definitively the extent of the impact of the QIOs and national QIO infrastructure on the quality of health care received by beneficiaries.” The first chapter traces Medicare quality assurance and its evolution from a program with a primary focus on utilization review and the control of outliers to one focused on improving the likelihood that health services will provide desired health outcomes. The second chapter summarizes key findings and the third reviews the Committee's first book. The fourth and fifth chapters examine future directions for and the oversight of the QIO program, respectively, and the last 8 chapters examine the operation...
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Hellinger FJ. Medicare's Quality Improvement Organization Program: Maximizing Potential. Ann Intern Med. 2008;148:488. doi: 10.7326/0003-4819-148-6-200803180-00027

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Published: Ann Intern Med. 2008;148(6):488.

DOI: 10.7326/0003-4819-148-6-200803180-00027

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