 The VHQC's clients included federal and state agencies, health care providers, managed care organizations, and commercial health insurers in Virginia and throughout the United States.As the Medicare-contracted Quality Improvement Organization for Virginia, they worked under the guidance of the Centers for Medicare and Medicaid Services (CMS), an agency of the United States Department of Health and Human Services.Established in 1984, VHQC is a 501(c)(3) not-for-profit corporation with clients in both the public and private sectors.