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About the HealthInsight Quality Innovation Network-Quality Improvement Organization


HealthInsight is leading health care quality improvement activities for the Medicare Program for a four-state region serving Nevada, New Mexico, Oregon and Utah under a five-year contract awarded by the Centers for Medicare & Medicaid Services (CMS). On July 18, 2014, HealthInsight became the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for the four states for a contract term extending through July 2019.    

HealthInsight has served as the Medicare QIO continuously for Utah since 1984 and in Nevada since 1988. The New Mexico Medical Review Association continuously held the Medicare QIO contract for its state since 1984 and affiliated with HealthInsight in 2012. Acumentra Health, which conducted Oregon’s Medicare QIO activity from 1984 to 2014, affiliated with HealthInsight in 2016 and is now known as HealthInsight Oregon.

Our Approach

As the QIN-QIO, HealthInsight is working with local health care providers in each of the four states to promote patient-centered care, make care safer and more affordable, and improve population health. We will engage hospitals, nursing facilities, physician practices, home health agencies, Medicare beneficiaries and families and related key stakeholders throughout the state to develop and apply proven strategies for delivering safer, more efficient care.

QIO Program 10 SOW Impact Statement Infographic
(Click to enlarge)

Find out more about the impact
of the QIO Program:

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Our Impact

HealthInsight QIN-QIO is proud to carry out the mission of the national Quality Improvement Organization Program, which has produced measurably better and safer care for Medicare beneficiaries and helped communities reduce health care spending.

In the work period that ended in July 2014, we and QIOs across the country worked closely with providers and with federal, state and private partners in local communities to improve care transitions and prevent more than 95,000 hospitalizations and 27,000 hospital readmissions among Medicare beneficiaries. From October 2010 to March 2013, CMS data show a 13.22 percent decline in hospital readmissions among Medicare beneficiaries in QIO-assisted communities, compared with a 12.55 percent decline nationally. These reductions, including in QIO communities, saved nearly $1 billion in health care costs. CMS findings showed that communities where QIOs played an active role in improving transitions achieved greater reductions in readmissions.

Our collaborative work led to impressive results in multiple projects to prevent harm and improve care for beneficiaries:

  • 85,149 fewer days with urinary catheters
  • 44,640 potential adverse drug events prevented
  • 6,250 nursing home residents living without physical restraints
  • 3,374 prevented or healed pressure ulcers in nursing home residents
  • 1,826 medical professionals using electronic health record data to report quality measures

For more information about the how QIOs are improving health care for the nation’s Medicare beneficiaries, visit the American Health Quality Association’s website.