Congressmen fight for state focus on quality improvement

Members of the U.S. House Ways and Means Health Subcommittee are urging the Department of Health and Human Services (HHS) to maintain a state-based structure for quality improvement organization (QIO) contracts as the department begins to implement QIO provisions included in a trade bill last year.

In a letter to HHS Secretary Kathleen Sebelius, Reps. Tom Price (R-Ga.) and Ron Kind (D-Wis.) explained their concerns with the Medicare Quality Improvement program provisions that were folded into the Trade Adjustment Assistance Reauthorization bill in October 2011.

Price, a physician, and Kind have co-sponsored legislation that would repeal the provisions of that trade bill and would ensure that QIOs keep a state-based focus. The bill allows these organizations to be regional or national, which advocates such as the American Health Quality Association have argued would compromise the working relationships QIOs have with their local communities. The AHQA worked with Price and Kind on their bill. The congressmen will continue pushing for their bill, even as they recognize that HHS must begin to implement the current law.

HHS should consider such factors as allowing QIOs to maintain a state-based structure, involving physicians in peer review of their states and keeping integrated functions of an QIO within one state-based organization, they said.

“The trade bill permits a QIO's discrete functions (e.g., hospital and nursing home technical assistance, investigation of beneficiary complaints) to be broken up among different organizations instead of integrating the functions within one state-based QIO,” Price and Kind wrote in their letter. “Improving quality requires a comprehensive and integrated approach—not a fragmented one—and this is best carried out by a single, locally focused organization.”

Access the letter to Sebelius.