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Quality Improvement Organizations (QIOs) monitor the appropriateness, effectiveness, and quality of care provided to Medicare beneficiaries. They are private contractor extensions of the federal government that work under the auspices of the U.S. Centers for Medicare and Medicaid Services (CMS).

In recent years QIOs have undertaken to facilitate continual improvement of health care services within their constituent communities in addition to their original and ongoing statutory audit/inspection role of medical peer review, i.e., akin to the traditional function of quality assurance. An example of current QIO quality improvement work is that of the federal Doctor's Office Quality Information Technology initiative, which

promotes the adoption of electronic health record systems and information technology in small-to-medium sized physician offices with a vision of enhancing access to patient information, decision support, and reference data, as well as improving patient-clinician communications.
The QIOs are represented nationally by the American Health Quality Association.