We are one of the first organizations in North and South Carolina to promote safer, more efficient patient care.
The Carolinas Center for Medical Excellence (CCME) has been a designated Quality Improvement Organization (QIO) by the Centers for Medicare & Medicaid Services (CMS) since 1984, focusing on better patient care, better population health, and lowering health care costs. Founded by physicians, CCME works with health care providers, health care associations, community leaders, and consumers on quality improvement initiatives to promote effective prevention and treatment of chronic disease, make care safer by reducing harm caused in the delivery of care, and make care more affordable.
From PRO to QIN-QIO
CCME is part of the largest program administered by CMS to improve health care quality at the community level. Founded in North Carolina in 1983, CCME, then known as Medical Review of North Carolina, Inc. (MRNC), worked to ensure that services provided under the Medicare program are reasonable, medically necessary, furnished in the appropriate settings, and of a quality that meets professionally recognized standards. MRNC served as the Peer Review Organization (PRO) in the Carolinas—the Medicare program utilization oversight contractor for the Health Care Financing Administration (HCFA, now CMS) that focused on retrospective review. The original contract for Medicare review in North Carolina was effective on August 1, 1984. In 1988, MRNC was awarded the PRO contract for South Carolina, operating under the subsidiary name of Carolina Medical Review.
In 1992, administrative changes at HCFA shifted the focus to developing a cooperative approach to quality improvement, and PROs became QIOs (Quality Improvement Organizations). The new name more accurately reflects the focus on improving the quality of health care. Further changes were made in 2014 by CMS transforming the QIO program to better facilitate and guide health care quality improvement efforts throughout the country. A part of this transformation included the creation of Quality Improvement Network-Quality Improvement Organizations (QIN-QIOs) comprised of three – six states. As a member of the Atlantic Quality Innovation Network (AQIN), the QIN-QIO for New York, South Carolina, and the District of Columbia, CCME serves as the QIO for South Carolina.