This article discusses the effect that the quality improvement organizations (QIOs) have achieved in the home healthcare industry under their contracts with the Centers for Medicare and Medicaid Services (CMS). Specific successes are related to partnerships between QIOs and home health agencies (HHAs) and the future of outcome-based quality improvement (OBQI) in improving acute care hospitalization (ACH). Data are from the OBQI evaluation system and show outcomes for the baseline collection period (May 2001-April 2002) through the remeasurement period (April 2003-July 2004). Data reported are for cardiac care measures that affect ACH.