CMSHealthDisparitie

The Centers for Medicare & Medicaid Services’ (CMS), Quality Improvement Organization (QIO) Program consists of a national network of 53 QIOs, one for each of the 50 United States (U.S.), the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.  QIOs work with health care providers, consumers and stakeholder groups to refine care delivery systems to make sure patients get the right care at the right time, particularly patients from underserved populations.  QIOs operate under three-year contracts with CMS.   The 9th Scope of Work (SoW) began in August 2008 and continues through July 2011.  For more information, please visit: www.cms.hhs.gov/QualityImprovementOrgs.

Under the Beneficiary Protection Theme QIOs continue to carry out statutorily mandated review activities, such as: reviewing the quality of care provided to beneficiaries; reviewing beneficiary appeals of certain provider notices; reviewing potential Emergency Medical Treatment and Active Labor Act (EMTALA) violations; and implementing quality improvement activities (QIAs) as a result of case review activities.
The activities involved in the Beneficiary Protection Theme focus on the following tasks:

While the Beneficiary Protection Theme does not have measures which directly address healthcare disparities, QIOs have been tasked with evaluating case review data in light of the racial/ethnic categories made available via the Social Security Act data.  The QIOs have also been tasked with identifying additional data necessary to evaluate health disparities, developing methods and processes to collect the necessary data, and then determining ways to evaluate this data in order to draw valid conclusions and identify appropriate next-steps.