Commentary: Concerns About Quality Improvement Organizations Actions Around Meaningful Use

The federal government is pressuring the medical community to reduce patient care costs while improving the quality of patient care to all patients, including Medicare beneficiaries. Congress, recognizing that hospital readmissions are too common and are costly and often avoidable, passed the Hospital Readmission Reduction Program (HRRP), which ties-in readmission metrics to monetary penalties to encourage hospitals to reduce readmission rates. Federal lawmakers also passed the Health Information Technology for Economic and Clinical Health Act (HITECH), which is intended to stimulate the rapid evolution and adoption of information technology in the healthcare industry, promote the development and use of clinical decision support (CDS) treatment algorithms, encourage active provider participation in discharge planning and care to decrease recidivism, and enhance care coordination through provider-patient communication.

Consistent with these legislative strategies, the Center for Medicare and Medicaid Services (CMS) appears to be encouraging contracted quality improvement organizations (QIOs) to adopt quality care principles (meaningful use criteria), created pursuant to HITECH, as additional criteria to be applied in the evaluation of the adequacy of care provided to Medicare beneficiaries under their jurisdiction.