One of the two Medicare Quality Improvement Organizations (QIOs) serving Massachusetts is changing. Effective June 8, 2019, KEPRO will be serving as the Massachusetts-specific BFCC-QIO, replacing Livanta.
A Beneficiary and Family Centered Care (BFCC) QIO manages all beneficiary complaints and quality of care reviews to ensure consistency in the review process. They also handle cases in which beneficiaries want to appeal a healthcare provider’s decision to discharge them from the hospital or discontinue other types of services.
The other type of QIO – a Quality Innovation Network (QIN)-QIO – will continue unchanged as HealthCentric Advisors. Among their other duties, QIN-QIOs develop strategic initiatives, such as reducing healthcare associated infections, reducing readmissions and medication errors; and work with providers (including but not limited to hospitals and nursing homes) to support clinical practices in using interoperable health information technology.