Telligen Quality Innovation Network – Quality Improvement Organization (QIN-QIO), in collaboration with the Centers for Medicare & Medicaid Services (CMS), is working throughout Colorado, Illinois and Iowa to achieve better care, better health for people and communities and more affordable care through quality improvement.
Telligen QIN-QIO drives quality in healthcare for Medicare beneficiaries by providing communities with technical assistance, convening learning and action networks for sharing best practices, and collecting and analyzing data for improvement. We align statewide partners and ongoing initiatives to create efficiencies and increase momentum.
QIN-QIO strategic initiatives:
Working with hospitals to reduce healthcare-associated infections (HAIs)
Convening communities to reduce readmissions and promote seamless coordination of care
Working with healthcare providers, communities and patients to improve medication safety and reduce adverse drug events
Working with nursing homes to improve care for residents and reduce healthcare-acquired conditions
Supporting clinical practices using electronic health records to improve care management and coordination
Helping home health agencies, physician offices and clinics spread the use of evidence-based practices and prevent cardiac disease through support of the Million Hearts initiative
Partnering with providers to empower persons with diabetes through Diabetes Self management Education (DSME)
Assisting providers with CMS quality reporting and value-based payment programs
Changes to the QIO Program
CMS has established a new structure for the Quality Improvement Organization Program that separates QIO functions into two major categories – medical case review and quality improvement work.
Medical case review will be performed by Beneficiary Family Centered Care Quality Improvement Organizations (BFCC-QIOs).
Quality improvement and technical assistance will be performed by Quality Innovation Network Quality Improvement Organizations (QIN-QIOs).
Both types of contracts cannot be held by the same organization. Changes also include a multi-state regional approach that replaces single-state QIO contracts for quality improvement work and extends contract cycles from three to five years.
Medicare Coverage Appeals and Quality of Care Concerns
KEPRO is the BFCC-QIO for Colorado, Illinois and Iowa and the new contact for Medicare coverage appeals and Quality of Care Concerns.
Contact KEPRO toll-free at:
Colorado - 1-844-430-9504
Illinois & Iowa - 1-855-408-8557
Visit www.keproqio.com for more information.