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1 Module Eight Assignment Adrian Geeslin Aspen University HCA320 Wanda Fletcher April 12, 2021
2 Module Eight Assignment Module Eight Assignment explains the Quality Improvement Organization and describes how it improves policies and healthcare. Medicaid and Medicare require various qualifications for acceptance. Alterations may be made for vulnerable populations. The ACA holds a large impact, negatively and positively, on Medicaid and Medicare regulations. As healthcare leaders, we are to advocate and ensure quality, cost-effective care for our patients. Quality Improvement Organization QIO Explained Quality Improvement Organizations (QIO) are composed of consumers, quality experts, and clinicians who seek to enhance the quality of care that Medicare patients receive. The purpose of a QIO is to examine quality in outcomes and find innovations for improvement. QIOs are divided into two types, Beneficiary and Family-Centered Care and the Quality Innovation Network (CMS.gov, 2020). QIO has a mission to improve efficiency, service quality, the economy, and healthcare effectiveness. The organization has three core functions. The first is to improve the overall quality of care. The second function is to protect Medicare's trust fund integrity by ensuring payments are only made for necessary and reasonable care in the most appropriate settings. Lastly, the QIO functions to address complaints and protect beneficiaries; complaints may include appeals, beneficiary complaints, and discerns within treatment and labor acts (CMS.gov, 2020). QIO Improves Policies and Healthcare CMS redesigned quality Improvement Organizations to enhance Medicare Beneficiary services; many changes were put forward. Quality improvement of separated from the case
3 reviews. Performance contract periods were extended from three years to five years. QIO restricted requirements were removed to each state having a single entity. Broad ranges of entities were considered by opening contractors to perform the work. Appeals and quality care concerns are now addressed by family-centered care (Nickitas, 2020). New skills through QIOs were developed and transformed. Medicare providers assist the transition to QIO programs. New methodologies and practices are being employed. Innovative approaches are developing for quality improvement purposes (Nickitas, 2020). Changes are maximizing Medicare tremendously. Education and collaboration of improved care are developing. Flexibility is being enhanced, improving delivered program values to beneficiaries, taxpayers, and patients. New models of care are supported and spreading for enhanced effectiveness. : Lastly, the quality improvement network is currently working with providers, beneficiaries, and stakeholders to improve targeted health conditions and overall health care (Nickitas, 2020).

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