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Medicare's quality improvement organization program value in nursing homes.

Anthony Shih¹, Diane M Dewar, Thomas Hartman

¹The Commonwealth Fund, New York, NY 10021, USA. ts@cmwf.org

Health Care Financing Review

|July 25, 2007

Summary

This summary is machine-generated.

The Centers for Medicare & Medicaid Services (CMS) Quality Improvement Organization (QIO) program offers good value for healthcare spending. Investment in nursing home quality improvement yields an estimated $2,063 to $7,667 per quality-adjusted life year (QALY) gained.

Related Experiment Videos

Area of Science:

Health economics
Healthcare policy
Quality improvement science

Background:

The Centers for Medicare & Medicaid Services (CMS) Quality Improvement Organization (QIO) program aims to enhance care quality for Medicare beneficiaries.
While the effectiveness of the QIO program has been studied, its economic value remains largely unexplored.

Purpose of the Study:

To evaluate the economic value of the CMS QIO program, specifically for nursing home quality improvement initiatives.
To determine the cost per quality-adjusted life year (QALY) gained through the QIO program's interventions.

Main Methods:

Cost-utility analysis was employed to assess the value of the QIO program.
The study estimated the investment costs and the quality-adjusted life years (QALYs) gained from nursing home quality improvement efforts.

Main Results:

The investment in the QIO program for nursing home quality improvement is estimated to range from $2,063 to $7,667 per QALY gained.
These findings suggest a favorable economic return on investment for the QIO program's quality improvement activities.

Conclusions:

The CMS QIO program represents a cost-effective use of healthcare resources.
Further research is recommended to fully understand the long-term value and impact of the QIO program, but current data indicate good value for healthcare dollars.