IPRO works with more than 150 managed care plans (MCPs) across the country, performing the full breadth of mandatory and optional EQR activities and providing innovative solutions and best practices to help our state clients monitor and improve MCP performance.
We have helped states at all stages of MCP evolution – from establishing their EQR programs through their transitions to new managed care models by conducting readiness reviews and providing technical assistance and program guidance.
As states with more established MCPs test new, innovative models for delivering high quality care, they require independent evaluation to assess the impact of the changes. In response to customers’ requests for support evaluating health care delivery system transformation programs, in 2021 IPRO established the Center for Program Evaluation. Staffed with quantitative and qualitative researchers and clinician-researchers, IPRO designs and implements applied research studies to help clients assess the impact of their programs and modify them for greater impact.
IPRO is also NCQA-licensed to conduct Healthcare Effectiveness Data and Information Set (HEDIS®) Compliance Audits. IPRO’s HEDIS services are delivered through our in-house Certified HEDIS Compliance AuditorsTM (CHCAs), augmented by a network of IPRO-trained independent consultants.
Focus on special populations
We work with diverse populations and plan types (physical health, behavioral health, pharmacy, dental, MLTC/MLTSS, QHP, dual-eligible, and special needs).
IPRO’s extensive experience with analyzing demographically diverse populations has helped us address the needs of rural populations, the underserved, ethnic and racial minorities, the chronically ill, persons with diabetes, persons with AIDS, those with mental illness, children with special healthcare needs, the aged, individuals with long-term care needs, the developmentally disabled, and others.
Contact Virginia Hill, RN, MPA, Vice President, Managed Care, 516-209-5567 or GHill@ipro.org
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
HEDIS Compliance Audit™ is a trademark of the National Committee for Quality Assurance (NCQA).