The Business of QIOs

Medicare pays nearly $300 million a year to 53 businesses called Quality Improvement Organizations, or QIOs -- one per state, plus the District, Puerto Rico and the U.S. Virgin Islands -- to measure medical care quality, work with hospitals and doctors to improve care and investigate patient complaints. Most are nonprofit, but some are for-profit businesses. QIOs have leveraged their positions and experience to compete aggressively for other government and private health care contracts, and as a group they have been collecting nearly as much from their outside work as from Medicare.


QIO name States served Revenue
(in millions)
Salary of highest
paid executive
Iowa Foundation for Medical Care IA, IL $74.5 $341,615
Island Peer Review Organization NY 44.6 412,294
Lumetra CA 36.1 395,708
Delmarva Foundation for Medical Care Inc. MD 28.1 209,183
Health Systems Advisory Group AZ, FL 25.0 NA
Qualis Health WA, ID, AK 23.6 335,990
West Virginia Medical Institute Inc. WV 22.9 264,774
Louisiana Health Care Review LA 20.8 216,538
Health Care Excel Inc. IN 17.3 245,759
Arkansas Foundation for Medical Care AR 17.0 285,974
Medical Review of North Carolina Inc. NC, SC 16.0 238,916
Georgia Medical Care Foundation GA 14.9 225,007
Connecticut Peer Review CT, RI 14.1 235,635
Texas Medical Foundation TX 13.9 312,125
Masspro MA 13.7 222,035
ProNJ NJ 12.3 519,084
Michigan Peer Review Organization MI 10.4 328,475
Oklahoma Foundation for Medical Quality Inc. OK 10.0 233,388
Colorado Foundation for Medical Care CO 10.0 209,826
Healthinsight UT, NV 9.4 196,822
Mountain-Pacific Quality Health Foundation MT, WY, HI 9.2 156,692
Metastar Inc. WI 8.8 204,105
Kansas Foundation for Medical Care KS 8.0 212,252
Quality Insights of Pennsylvania PA 7.8 137,007
Missouri Patient Care Review Foundation MO 7.2 150,688
Virginia Health Quality Center VA 7.0 199,867
Oregon Medical Professional Review Organization OR 6.4 207,589
Qsource TN 6.0 168,371
Stratis Health MN 5.9 195,639
Alabama Quality Assurance Foundation Inc. AL 5.6 174,013
Mississippi Information and Quality Healthcare MS 4.7 165,536
Northeast Health Care Quality Foundation ME, NH, VT 4.4 216,015
Quality Improvement Professional Research Organization Puerto Rico 3.9 NA
Cimro of Nebraska NE 3.3 107,629
New Mexico Medical Review Association NM 3.2 154,053
North Dakota Health Care Review Inc ND 3.0 185,159
South Dakota Foundation for Medical Care SD 2.6 152,485
Delmarva Foundation District of Columbia DC 2.1 178,515
Health Care Excel of Kentucky Inc. KY 1.9 NA
Quality Insights of Delaware DE 1.6 NA
Virgin Islands Medical Institute Inc. Virgin Islands 1.1 154,990

SOURCES: QIO tax returns and financial statements, interviews | The Washington Post


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