QIOs prevent thousands of hospitalizations, readmissions

Quality Improvement Organizations (QIOs), through their work with healthcare providers, and federal, state and private partners, prevented more than 95,000 hospitalizations and 27,000 readmissions among Medicare beneficiaries over a three-year period, according to the American Health Quality Association (AHQA).

Data from the Centers for Medicare & Medicaid Services indicates hospital readmissions among Medicare beneficiaries fell 13.22 percent in QIO communities between October 2010 and March 2013, compared to only 12.55 percent nationally. Hospital admissions also declined more in QIO communities (8.39 percent) than nationally (8.12 percent).

"QIOs work in close partnership with physicians, nurses and other members of the interdisciplinary team across settings--forming a network that helps patients remain healthy long after they leave the hospital," said AHQA President Adrienne Mims, M.D., vice president, chief medical officer of Atlanta-based Alliant GMCF, the QIO for Georgia in the announcement. "Because QIOs are part of the local community--neighbors, in fact--we're able to constantly innovate and adapt, ensuring our efforts meet the unique needs of local seniors and their families. Successfully reducing readmissions takes the entire community."

In addition to improvements at a hospital-wide level, QIOs were also associated with unit-wide improvements, including a 53 percent drop in central line-associated bloodstream infections between February 2011 and August 2013, according to the statement. Moreover, QIO-assisted hospitals took steps to reduce catheter-associated urinary tract infections by reducing the number of days Medicare patients used a catheter by more than 85,000 days nationwide.

Improved care transitions due to lower hospitalizations, including those in QIO communities, saved healthcare providers nearly $1 billion, the AHQA said.

In May, CMS announced it would restructure the QIO program to make it more efficient, bringing on two contractors to oversee quality improvement and prioritizing groups that work directly with providers toward patient care for contracts, FierceHealthcare previously reported.

To learn more:
- read the AHQA statement

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