Quality Improvement Activity

The Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, awards Quality Improvement Organization (QIO) contracts for every US state and territory. The current three-year contract is known as the 9th Statement of Work (SOW). The QIO program ensures the quality, effectiveness, efficiency, and economy of health care services provided to people with Medicare. Across the country, QIOs serve as Medicare’s grassroots connection to engage health care providers, stakeholders, and people with Medicare in support of the program’s quality goals. The Carolinas Center for Medical Excellence (CCME) has been designated by CMS as the QIO for both North and South Carolina.

The Carolinas are home to our dedicated and experienced staff, all of whom have a vested interest in health care quality improvement. We value our QIO designation and the tremendous opportunity it affords us to assist our colleagues in all health care settings to do their work better. CCME has performed this role since the inception of the QIO program and operated as one of Medicare’s peer-review organizations (a precursor to the QIO) since 1984. Our solid portfolio of quality improvement work has established a strong foundation for success and through this, CCME has become a recognized leader for its work in health care quality.

During the 9th SOW, CCME will center its quality improvement activities on:

• Beneficiary Protection – CCME will continue to work on beneficiary protection activities with two areas of focus: statutory and regulatory mandated review, and quality improvement.

• Patient Safety – CCME will be focusing on drug safety as well as working with participating hospitals and nursing homes to improve performance on a set of important processes, resulting in positive outcomes that will reduce patient risk factors.

• Prevention – CCME will be working with participating primary care physician practices to implement care management processes, using their certified electronic health record (EHR), that will focus on breast and colorectal cancer screenings and influenza and pneumococcal vaccinations.

For more information on the QIOs and the QIO Program, please visit www.QIOSynergy.org.