Avar Consulting
Beneficiary and Family Centered Care-
Quality Improvement Organization
(BFCC-QIO)
What is the QIO Program?
Led by the Centers for Medicare & Medicaid Services (CMS), the Quality Improvement Organization (QIO) Program is one of the largest federal programs dedicated to improving health quality for people with Medicare.
The QIO Program serves people with Medicare, health care providers and communities. All initiatives are designed to improve health care quality, access, value and equity for people with Medicare. Core functions of the QIO program include:
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Using data to track health care quality improvements;
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Protecting the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and necessary and that are provided in the most appropriate setting; and
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Protecting beneficiaries by addressing individual complaints, such as beneficiary complaints; provider-based notice appeals; violations of the Emergency Medical Treatment and Labor Act (EMTALA); and other related responsibilities as articulated in QIO-related law.
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What are Beneficiary and Family Centered Care (BFCC)-QIOs?
BFCC-QIOs help Medicare beneficiaries with their concerns about the quality of care they receive from a Medicare provider. The Quality Improvement Organization (QIO) is a group of health quality experts, providers, and consumers organized to improve the quality of care delivered to people with Medicare.
The BFCC-QIOs, Acentra Health (formerly Kepro) and Livanta, review complaints and quality of care, and help to improve the effectiveness, efficiency, economy and quality of services provided to people with Medicare.
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Find Your BFCC-QIO Area For Help with Appeals and Complaints
There are two QIOs (Acentra and Livanta) that work directly with beneficiaries to address their appeals and complaints. QIOs serve all U.S. states, territories, and the District of Columbia. The country is divided into regions, with each region being assigned to one of these two QIOs.
For more information about the program, visit the QIO Program Website.
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