Frequently Asked Questions (FAQs)
Answers to Common Questions About Participating in CMS’ Quality Improvement Program with the Northeast or Mid-Atlantic CMS QIN-QIO Team.
This is a CMS-funded program, so there are no costs to your organization for participating or receiving support.
CMS identified eligible organizations (i.e., hospitals, nursing homes, and outpatient clinical practices) based on several factors, including:
– Size: Smaller organizations may benefit from targeted support
– Location: Rural areas often face unique challenges
– Populations served: Underserved communities may require additional support
– Data: Organizations whose data suggest additional support could improve quality outcomes
CMS’ Quality Improvement Program is a five-year initiative (2025–2030) designed to be iterative. Each year includes assessments and updates to your engagement strategy and quality action plan, allowing your organization to adapt, refine, and continuously improve quality over time.
The time commitment is flexible, and support is tailored to your organization’s capacity and needs. We’ll work together to develop engagement strategies that outline how your organization will participate. Your plan will be reviewed and updated annually, or more frequently if needed, to ensure it remains aligned with your priorities.
The QIO program focuses on CMS-identified priority areas that support high-quality and safe care. This includes:
– Patient Safety: Enhancing infection prevention and control (e.g., CAUTI, CLABSI, CDI, MRSA, SSI, HAI), adverse drug event prevention (e.g., opioids, anticoagulants, diabetes medications), and reducing other safety events (e.g., falls and pressure injuries)
– Care Coordination: Improving transitions of care and reducing avoidable hospitalizations
– Chronic Disease Prevention & Management: Increasing vaccination rates and enhancing preventative care and outcomes for patients with diabetes, hypertension, and chronic kidney disease
– Behavioral Health Integration: Enhancing screening and management of depression, suicide risk, and substance use disorders
QIOs also help providers strengthen quality management systems, emergency preparedness, workforce planning, supply chain management, drug shortage mitigation, cybersecurity readiness, and optimization of health information technology. Participants work with the Mid-Atlantic CMS QIN-QIO team to focus on the CMS-identified areas most relevant to their priorities.
No. We will collaborate with you to identify the areas to focus on, sharing CMS-identified priorities and aligning them with your organization’s goals. This ensures your efforts are targeted, relevant, and meaningful.
You will receive customized assistance, guidance on best practices, data analysis, and access to resources designed to help achieve measurable improvements in patient care.
Participation provides your organization with no-cost support, access to quality experts, evidence-based tools, and a learning community where you can share success strategies and problem-solve with peers. Additional benefits include:
– Strengthened ability to meet and exceed CMS quality goals
– Opportunities to improve patient outcomes and care delivery
– Demonstrated commitment to quality improvement to CMS and stakeholders
The CMS Quality Improvement program is designed to complement, not duplicate, your existing initiatives. Our team provides tailored support, data-driven insights, and evidence-based resources to maximize the impact of your current efforts. Participation also helps ensure alignment with CMS quality priorities.
Even high-performing organizations can benefit. Participation demonstrates your commitment to CMS quality goals, provides opportunities to share successful strategies, and allows you to learn from other top-performing organizations. It helps sustain excellence, identify emerging opportunities, and showcase your leadership in advancing quality care.
Participation can strengthen your organization’s performance in CMS payment programs, including value-based care initiatives. By enrolling, you demonstrate leadership’s commitment to quality improvement, an activity that may also qualify as an Improvement Activity under MIPS. The program’s focus areas align directly with CMS quality reporting and payment programs, helping you meet requirements while advancing patient care. In addition to strengthening performance, our reporting experts understand the program details and can help guide you through reporting requirements. Learn more here about CMS alignment or contact us.
Schedule a one-on-one conversation with a local Quality Improvement Advisor, or submit questions to us at QIN-QIOR2@ipro.org.