JAMA article: Quality Improvement Organizations do not increase quality indicators.

The June 15, 2005 issue of JAMA published an article that evaluated the impact of Quality Improvement Organizations (QIO) on "quality" of care for Medicare beneficiaries". Until 1992 the Medicare program's focus on quality problems with Medicare was on the PSROs and the PROs. These efforts were criticized for lack of efficacy and emphasis on cost containment. In 1992 emphasis was shifted to the QIOs to work with hospitals regarding quality improvement programs. The authors of this article report that there was no improvement noted in 14 out of 15 quality indicators between hospitals who took part in the program and those who did not. So it appears that this quality program did not increase quality of care. Currently $ 200 million is allocated annually for quality improvement. Medicare has recently signed a new 3 year contract with QIOs to continue their efforts in quality promotion. Let's hope the new efforts work out better than the old ones but perhaps calling a project "quality improvement" and spending large amounts of money are not enough.