Issue Brief

No. 774

Contracting for Quality: Medicare's Quality Improvement Organizations
June 3, 2002

Author

Lisa Sprague, MBA

Summary

This paper examines the role of quality improvement organizations (QIOs, formerly known as PROs, or peer review organizations) in improving the quality of medical care delivered to Medicare beneficiaries in both fee-for-service and managed care environments. It looks at the expansion of the QIOs' portfolio in their seventh contract cycle to include quality improvement activities in nursing homes, home health services, and physicians' offices as well as responsibilities for public education. The paper explores the evolution of QIOs, changes in their priorities over time, and the projects in which they are engaged. It also considers their role in the formulation and execution of a national quality agenda.

Related Materials

See also the entry for the related Forum Session.

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