Challenge

How do you ensure that American seniors are getting high-quality care under Medicare, the country’s largest health insurance program? The Centers for Medicare & Medicaid Services (CMS) established the Quality Improvement Organization (QIO) Program to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries.

Westat, in collaboration with partner Avar, is monitoring the implementation of the QIO Program to ensure it is effective in achieving established goals and protecting both Medicare beneficiaries and the Medicare trust fund.

Solution

Westat is supporting CMS by providing oversight and evaluation of the Beneficiary and Family Centered Care (BFCC) QIO Program. Initiatives include

• Ensuring beneficiary case reviews are efficient, systematic, and thorough
• Using national data to identify areas for quality improvement and increased patient safety
• Collaborating with CMS and other partners to support the rights and services for Medicare beneficiaries
• Engaging beneficiaries and their families to improve how health care is delivered
• Raising awareness about beneficiary rights under the Medicare program

Results

Westat ensures consistent program implementation across the nation and identifies improvements aimed at making CMS services more beneficiary- and family-centered.