The Centers for Medicare & Medicaid Services should preserve state-based quality improvement organizations for Medicare oversight, according to a large number of healthcare groups, including the American Health Care Association.

Nearly 50 medical societies signed a letter circulated by the American Medical Association last month, opposing the potential replacement of state-level QIOs with regional ones. AHCA/NCAL, the nation’s largest long-term care provider group, expressed support of this position on Tuesday, joining groups such as the National Rural Health Association and the American Health Quality Association, which represents QIOs.

“For more than a decade, our skilled nursing members from across the country built trusted, productive working relationships with their QIO,” said Mark Parkinson, AHCA president and CEO. “Attempting to recreate these relationships with an organization operating several states away dismantles the progress the profession has made, and takes precious time and resources away from a currently beneficial system.”

QIOs are tasked with sharing information about best practices with healthcare providers participating in Medicare, including nursing homes.

QIO efforts have helped dramatically decrease hospital readmissions, according to a study published earlier this year in the Journal of the American Medical Association. This success was driven in large part by QIOs’ ability to work effectively at the state and local level, which could be compromised by the possible changes, according to the AMA letter.