Quality Improvement Organization (QIO) Priorities

Colorado Foundation for Medical Care (CFMC) has been awarded a three-year contract by the U.S. Centers for Medicare & Medicaid Services (CMS) to serve as the Medicare Quality Improvement Organization (QIO) for Colorado.

The QIO program is a major force and partner for the continual improvement of health and healthcare for all Americans. QIOs in each state as well as the District of Columbia, Puerto Rico and the U.S. Virgin Islands help achieve national quality goals through focused efforts at the community level. The mission of the QIO Program is to improve the effectiveness, efficiency, economy, and quality of services delivered to people with Medicare.

CFMC's current contracted work as a QIO began August 1, 2011 and will conclude on July 31, 2014. To achieve the bold new goals established by CMS, QIOs across the nation will focus on three broad Aims:

  • Better patient care
  • Better health for people and communities
  • Lower costs of care through improvement

Additionally, QIO efforts will support the goals of the U.S. Department of Health and Human Services' National Quality Strategy.

As the Medicare QIO for Colorado, CFMC will partner with healthcare providers, patients and quality stakeholders throughout the state to:

Deliver Beneficiary and Family Centered Care. CFMC will focus on addressing individual patient and family preferences, needs and values. Specifically, this includes case review activities, including quality of care reviews, Emergency Medical Treatment and Labor Act (EMTALA) reviews, provider discharge/service denial or discontinuation of healthcare services appeals, higher-weighted diagnosis-related group reviews and others. Learn more.

Improve Individual Patient Care. CFMC will work with Colorado hospitals to reduce healthcare-associated infections (HAI) including central line bloodstream infections by implementing the Comprehensive Unit-Based Safety Program (CUSP), then expand efforts to encompass catheter-associated urinary tract infections, Clostridium difficile and surgical site infections. All Medicare-participating hospitals also will receive technical assistance for reporting inpatient and outpatient quality data to CMS. In nursing homes, CFMC's work will initially target pressure ulcers and physical restraints, then evolve to address other healthcare-acquired conditions, such as falls and catheter-associated urinary tract infections. Learn more.

Integrate Care for Populations and Communities. CFMC will bring together hospitals, nursing homes, patient advocacy organizations and other stakeholders in community coalitions. Goals are to build capacity for improving care transitions, reduce unnecessary hospital readmissions and support communities in efforts to obtain funding through the Community-Based Care Transitions Program (CCTP), Section 3026 of the Affordable Care Act. Learn more.

Improve Health for Populations and Communities. CFMC will assist physician practices that want to use their electronic health record system to coordinate preventive services and report related quality measures to CMS. Practices also can participate in a learning network focused on reducing patient risk factors for cardiac disease. CFMC is also working in partnership with the Colorado Regional Extension Center (CoREC) to promote health IT integration into clinical practice. Learn more.

We are currently engaging providers at all levels of performance in rapid-cycle projects for collaborative learning and action and we welcome participation by all who want to contribute to better care, better health and lower costs through improvement. We can offer you free knowledge and tools for improving health quality, efficiency and value. We can also help you take action on your commitment to initiatives such as the Partnership for Patients and Value Based Purchasing. Explore our site and learn more. We look forward to working with you.

CFMC has also been awarded a QIO support contract by CMS to serve as the Integrating Care for Populations and Communities National Coordinating Center. As the National Coordinating Center, CFMC will lead 41 QIOs in 53 states and territories as they identify target communities within their states and work to implement improvement plans that coordinate hospital and community-based systems of care to improve care transitions and reduce unnecessary hospital readmissions. Learn more.

Contact Information

For more information contact Jolene Gurtis at 303-695-3300 ext. 3134 or jgurtis@cfmc.org.

Colorado Foundation for Medical Care (CFMC), the Medicare quality improvement organization for Colorado, prepared this material under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS Policy.