QIO chief admits complaint system needs work

Share this content:

The association representing Medicare quality improvement organizations is refuting claims that QIOs are ineffective. But it acknowledged that certain aspects of the system are broken.

An editorial in USA Today was "right to point out that the Medicare complaint program needs to be fixed," wrote David Schulke, executive vice president of AHQA, in a letter to the newspaper's editor. AHQA has asked the Centers for Medicare & Medicaid Services for funds to educate patients about their right to file complaints.

While AHQA wants to "respond to complaints by telling patients what happened and why," Medicare does "not currently allow us to do that," he wrote. He also said QIOs should help those doctors who provide good care but work in a system beset with miscommunication and other problems.

QIOs have been under the scrutiny of the Senate Finance Committee, which is investigating the possible misuse of funds. Medicare pays QIOs about $300 million a year to investigate complaints and improve nursing home care, as well as hospital and doctor care.