Purpose and Objectives of the Internal Quality Improvement

13000 - Purpose and Objectives of the Internal Quality Improvement Program (IQIP) (Rev. 23, Issued: 12-03-15, Effective: 12-03-15, Implementation; 12-03-15) Each QIO must develop and maintain an Internal Quality Improvement Program (IQIP), also known as an Internal Quality Control (IQC) program or a Continuous Internal Quality Improvement Program (CIQIP), in accordance with provisions in its QIO contract. The purpose of the IQIP requirement is to support and foster an environment of continuous quality improvement within the QIO through ongoing assessment and improvement in areas that are critical for successful contract performance. The objectives of the contractual requirements for an IQIP are to: • Demonstrate continuous improvement in the quality of services provided by QIOs in support of the performance objectives, functions, tasks, and subtasks identified in QIO contracts • Develop and implement a plan that ensures all aspects of QIO activities run efficiently, comply with the contract, and are consistent with CMS’s goals and objectives for the QIO contract • Document and share with CMS, other QIOs, providers, or key stakeholders, its lessons learned in carrying out its functions to help advance the quality and effectiveness of the QIO program • Improve the reliability, accuracy, consistency, and timeliness of data analysis and reporting, and case review processing and decision-making • Provide contract services that consider and meet the needs of customers, and result in high levels of customer satisfaction • Identify opportunities to enhance internal and external customer satisfaction, including but not limited to the need for and development of additional provider, practitioner, beneficiary, or family/caregiver education regarding QIO review processes and criteria • Ensure the support, understanding, and participation of all beneficiaries, practitioners, providers, and other constituencies that are affected by QIO activities • Ensure compliance with the requirements of statutes, regulations, policy, and the QIO contracts