CMS Announces QIO Program 13th Scope of Work
The Centers for Medicare and Medicaid Services (CMS) recently posted updates to the QIO Program website, noting the 13th Scope of Work launch to support health care quality improvement, as well as the Department of Health and Human Services Secretary’s Make America Healthy Again (MAHA) initiative.
Highlights of the announcement include:
- Seven QIN-QIOs will work directly with nursing homes, hospitals, and physician offices to improve the quality and safety of care for people with Medicare (May 2025-May 2030).
- Services provided: Direct technical assistance and resources, advanced data analytics support, evidence-based intervention recommendations, customized training and education.
- Focus areas: Disease prevention, quality and patient safety, chronic conditions management, behavioral health, emergency preparedness, care coordination, and workforce challenges.
The table below lists the QIN-QIO contractor awardee per region and the states served by that region.
CMS QIN-QIO 13th Scope of Work Contractors (2025 – 2030)
| Region | CMS QIN-QIO Region | Awardee | States Served |
| 1 | Northeast
CMS QIN-QIO (1) |
Superior Health Quality Alliance, Inc. (SHQA) | Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New Jersey, New York, Puerto Rico, and the Virgin Islands |
| 2 | Mid-Atlantic
CMS QIN-QIO (2) |
Island Peer Review Organization, Inc. (IPRO) | Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia |
| 3 | Southeast
CMS QIN-QIO (3) |
Health Quality Innovators HQI) | Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee |
| 4 | Great Lakes
CMS QIN-QIO (4) |
Superior Health Quality Alliance, Inc. (SHQA) | Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin |
| 5 | Southcentral
CMS QIN-QIO (5) |
TMF Health Quality Institute | Arkansas, Louisiana, New Mexico, Oklahoma, and Texas |
| 6 | Midwest
CMS QIN-QIO (6) |
Telligen, Inc. | Iowa, Kansas, Missouri, Nebraska, Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming, Alaska, Idaho, Oregon, and Washington |
| 7 | West
CMS QIN-QIO (7) |
Health Services Advisory Group (HSAG) | Arizona, California, Hawaii, Nevada, and the Pacific Territories |
AHCA will continue to seek more information from CMS on this new Scope of Work and advocate for meaningful support to nursing homes provided by the QIOs. Please send questions to [email protected].
Posted in Skilled Nursing Facilities
