Odds are it's not your campaign structure at all. It's your relevancy in their eyes and they're very very very strict on that.
Here's my situation: local geo-targeting, professional services industry (5 main types of counseling services). You cannot get more relevant on a keyword level than say... psychotherapist in springfield, WA. Or can you? If Springfield, WA was one of my stronger performing market areas (based on GA stats), wouldn't it make sense to create a more targeted campaign around that particular market? I tried this with one of my cities and it bumped up the QS of a generic keyword, ie., "psychotherapist", from 6 to 7. Also, I read all around the web that if you are suffering from a poor QS issue, you should create more targeted ad groups with only a couple keywords in each.
Definitely makes sense. Moreover, that way you can set different bids to different Geo locations. Nevertheless, in my opinion, restructuring a profitable campaign should be done carefully, like paving a new route on a bustling road. Keep the cancellation option open.