West Virginia Medical Institute: the Quality Improvement Organization for West Virginia.
The Federal Quality Improvement program, (QIO), charged with quality improvement and some case review activities is conducted under a contract with the Centers for Medicare and Medicaid Services (formerly HCFA), now CMS. Every state has one organization which handles this program and in West Virginia, the West Virginia Medical Institute has been responsible for this work for over 30 years. When case review is involved, the conclusions are communicated to individual physicians and hospitals. Occasionally, serious quality of care concerns are encountered. This article explains the case review process and why cases are selected, and also makes suggestions about how individual physicians may appeal or respond. It is designed to help enhance understanding of the program and its goals.
Brehm
John G
JG
West Virginia Medical Institute, Charleston, USA.
Smith
Stephen M
SM
D014487:Centers for Medicare and Medicaid Services, U.S.; D006801:Humans; D006278:Medicare / Q000592:standards*; D018024:Peer Review, Health Care; D011366:Professional Review Organizations; D011787:Quality of Health Care / Q000592:standards*; D014481:United States; D014600:Utilization Review / Q000592:standards; D014903:West Virginia