QIOs provide useful services for the elderly
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By Julie Ann Anderson  November 8, 2013 12:00 am

Most people are not aware there are a number of elder services that can be useful in helping seniors and those who care for them. Such elder services include Quality Improvement Organizations (called QIOs) that are set up in each state.


What is a QIO?

According to the official Medicare website, QIOs are “private, mostly not-for-profit organizations staffed by professionals, mostly doctors and other health care professionals, who are trained to review medical care and help (Medicare) beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available throughout the spectrum of care.”


QIOs are in every state

In other words, there is a government-financed organization in each state (as well as in the District of Columbia, Puerto Rico, and the U.S. Virgin Islands), which is set up to help Medicare recipients who have issues with the care they receive. As IPRO, which is the QIO for New York, puts it, “the QIO program focuses on enhancing the services that Medicare beneficiaries receive while protecting the Medicare Trust Fund through the promotion of an effective and efficient delivery system.”

Essentially, the QIOs provide elder services to help those who have serious, legitimate complaints about their medical care. For example, if you feel that you have been released from a hospital too soon, contacting a QIO can help resolve the problem. Other typical QIO issues are medication errors, unnecessary surgeries, incomplete discharge instructions and changes in conditions that were not treated.


The process

After a QIO reviews your medical files and your complaint, it will tell you if the care you received met professionally recognized standards of health care. If it didn’t, the QIO will work to improve future care.

Although a QIO has no legal authority, the organization can review your medical records and contact health care providers with which you have disputes and recommend solutions to the problems that have arisen. Because they are connected with the government, the organizations have more clout than an ordinary individual; health care providers are more likely to listen and to respond quickly when dealing with a QIO. Issues that require a timely response are handled under an “immediate advocacy” program, which ensures that the problem is resolved as quickly as possible.

To find the QIO that operates in your region, go to the American Health Quality Association's website at www.ahqa.org.


Julie Ann Anderson is the owner of Home Instead Senior care office in Rohnert Park; mother of two and passionate about healthy living at all ages. Having cared for her parents, she understands your struggles and aims, through her website, www.homeinstead.com/sonoma to educate and encourage seniors and caregivers. Have a caregiving or aging concern? She’d love to hear from you at 586-1516 anytime.

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