QIOs say providers should help fund Medicare quality initiatives

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Medicare's quality improvement organizations should be allowed to seek funding from providers, including, nursing homes, hospitals, medical practices and health plans.

That's the view of the American Health Quality Association, which represents QIOs, in a letter to Center for Medicare & Medicaid Services Administrator Mark McClellan. A report from the Institutes of Medicine made a similar suggestion in March.

Funding currently allows QIOs to review only 10% to 15% of Medicare-funded nursing homes, the AHQA said. Its letter from AHQA Executive Vice President David Schulke recommended various changes to improve QIO operations, including more funding, longer contracts and increased contact with beneficiaries regarding provider complaint investigations.

QIOs have come under fire recently from Senate Finance Committee Chairman Charles E. Grassley (R-IA), who has questioned their effectiveness, finances and possible conflicts of interest with the providers they oversee. Any changes made to the QIO program could be accomplished through a combination of legislation and CMS administrative actions, the AHQA said.