Quality Improvement Organization Manual (Pub. 100-10), Ch. 15 § 15210
Methods of Evaluation
15210 - Methods of Evaluation
(Rev.31, Issued: 07-21-17, Effective: 07-21-17, Implementation: 07-21-17)
Substantial elements of QIO contracts are performance-based, such that a QIO is
assessed relative to specific performance measures established in the contract.
Performance on these measures can be used to objectively make determinations about
non-competitive renewals and/or be used as objective criteria in competitive
procurements. Additionally, CMS may also assess QIO performance based on annual
routine assessment, regularly scheduled teleconferences, data analysis, off-site reviews of
QIO project activities, contract deliverables, reporting, data reports, interviews with QIO
staff, customer satisfaction and/or an examination of other pertinent records.
CMS follows federal acquisition regulations when assessing QIO contractor performance
on the contract. CMS conducts contract performance monitoring activities throughout
the contract term and will act upon findings as necessary.
CMS performs regular formal assessment of each QIO’s overall contract performance
based on the general evaluation criteria and standards identified in each QIO contract.
The assessment is provided to the QIO through the CMS Contracting Officer using the
Contractor Performance Assessment Reporting System (CPARS) criteria used in
performance evaluations: Quality, Schedule/Timeliness, Cost/Price Control, Business
Relations, Management, and Small Business. CMS considers the published general
evaluation criteria and standards within the Quality sub-factor within the CPARS
assessment of overall contractor performance.
CMS performs regular program impact assessments and may contract with an
independent entity to perform assessment of overall QIO Program performance.
Program evaluations are conducted separately from individual QIO contractual
performance evaluations. CMS makes QIO Program performance assessment results
available to each QIO as part of regular QIO program evaluations.