Questioning the need for QIOs

As I've posted before (Are QIOs effective?), the 40 Quality Improvement Organizations (QIOs) contracted by the Center for Medicare and Medicaid Services (CMS) have been busy trying to demonstrate their usefulness in the wake of studies showing that historically they have been of limited effectiveness. The Wall Street Journal has an article on the topic today. (Health-Care Quality Programs Under Fire.)"There is some question whether outsiders can really come in and help you improve quality, and whether this is the right model and the right way to spend the money," says Margaret O'Kane, president of the nonprofit National Committee for Quality Assurance, which sponsors several quality programs and accredits managed-care companies. "There isn't that much hard evidence that they are doing any good, and it is probably a good thing to step back and ask if there is another way."However, as much as I've been a critic of the QIO system, there is definitely something to be said for Medicare throwing its weight around. When it does so in the right way the results are striking. That's why it's a good thing that much of the pressure for QIO reform is coming from CMS itself.