Annual Medical Services Review Report

All Medicare Quality Improvement Organizations (QIOs) produce an Annual Medical Services Review Report, which includes the number of Medicare beneficiary complaints about the quality of care Medicare beneficiaries receive. Stratis Health is the Medicare QIO for Minnesota that reviews these complaints for the Minnesota Medicare population.

Quality Improvement Organizations (QIOs) review complaints about the quality of care that Medicare patients receive. The complaints come from Medicare patients and/or their representatives. In reviewing a complaint, the QIO looks at the services a patient received and decides whether those services met standards of health care that are commonly accepted by physicians and others in the medical community. Quality of care complaints may involve more than one concern, due to the following:

1. More than one quality of care concern in a single setting
2. The same quality of care complaint for a single-patient episode of illness involving multiple settings and/or providers
3. More than one quality of care concern involving more than one setting and/or provider

For example, a Medicare beneficiary complaint related to a hospital stay might include several different quality of care concerns or a beneficiary who was hospitalized and then moved into a skilled nursing facility or other outpatient hospital setting might have the same quality of care concern occur in each type of setting. Consequently, for a specific setting or provider type, the number of quality of care concerns confirmed by the QIO may exceed the number of beneficiary cases reviewed.

From July 1, 2010 through June 30, 2011, Stratis Health completed reviews on 42 cases. At the time of this report, Minnesota had 829,833 Medicare Part A beneficiaries.

Minnesota's Annual Medical Services Review Report (3-page PDF)