Data Validation and Administrative Contractor

Center for Medicare and Medicaid Services : Data Validation and Administrative Contractor




For more than 40 years, the Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid Services (CMS) has executed federally mandated contracts to improve quality in a wide variety of settings through its Quality Improvement Organization (QIO) program. More recently, CMS has awarded quality improvement (QI) contracts with other organizations focused on specific networks of providers. Collectively these organizations are accountable for providing technical assistance for QI to healthcare delivery organizations including hospitals, nursing homes, primary and specialty care practices serving both large and small, rural and medically underserved communities. In achieving this work nationally,CMS has provided support to national contracts to facilitate achievement of the program aims. 

Through a combination of service delivery reform and technical assistance, the programs managed through the Center for Clinical Standards and Quality’s (CCSQ) – Quality Improvement and Innovation Group (QIIG) have together achieved dramatic improvements in quality, outcomes and cost efficiency in hospitals, nursing homes, and communities using an adaptive QI approach to program design. Their aligned efforts toward assisting providers with QI activities have driven decreases in hospital admissions and readmissions, healthcare-associated infections (HAI), hospital-acquired conditions (HAC), adverse drug events (ADE), improvements in management of chronic diseases, and improvements in nursing home care quality. 


The new structure and innovative network of Medicare QI leaders has landed in the National Quality Improvement and Innovation Contractors (NQIIC) Community. CMS is in the process of awarding the next round of five year contracts through the NQIICs, a set of QI contractors that have the capability of achieving large scale improvement results using effective and innovative QI strategies that are data driven, transparent, and empower patients, families and clinicians to make decisions about their healthcare.  


To realize this potential, Bizzell is providing comprehensive, streamlined, and technology-driven large-scale data analytics, data validation, data visualization, communications, and results-oriented learning action networks support to enable every NQIIC contractor to assist CMS in achieving its aims of: 1) Improving behavioral health, including opioid abuse, 2) Improving public health through improved chronic disease management, 3) Increase patient safety, 4) Increase quality of care transitions, and 5) Improving long term care.

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