Patricia Simino Boyce
– (Lake Success, NY) – IPRO has obtained a four-year renewal of a contract that provides independent quality improvement services to support New Jersey’s oversight of five managed care plans responsible for delivering healthcare to 1.7 million Medicaid members across the state.
Under federal law, states enrolling Medicaid members in managed care plans are required to engage designated External Quality Review Organizations (EQROs) like IPRO to evaluate and improve the quality of services delivered across a variety of settings. New Jersey’s EQRO activities include technical support to the Department of Human Services, Division of Medical Assistance and Health Services, in such areas as medical record review, onsite assessment of plan operations, validation of plans’ performance measures, evaluation of quality improvement projects and engaging plans in focused quality studies.
Medicaid members include families, pregnant women, single adults, childless couples, people who are aging, blind or who have disabilities, as well as individuals who qualify for long-term care services. Quality improvement efforts address critical topics such as pediatric and maternal health, chronic care, behavioral health issues/addiction services and adolescent obesity.
“We’re pleased and grateful that after more than six years of EQRO activity in New Jersey, the state awarded us an additional four-year quality improvement contract,” according to IPRO’s Senior Vice President and Chief Medical Officer Clare B. Bradley, MD, MPH.
IPRO has a thirty-year history of providing EQRO services across the U.S. and is currently the designated contractor in eight states including New Jersey, New York, Kentucky, Louisiana, Minnesota, Nebraska, Rhode Island and Pennsylvania—as well as in Puerto Rico. IPRO’s Managed Care Department consists of credentialed staff including physicians, nurses, researchers, task leaders, certified HEDIS compliance auditors, biostatisticians, data analysts, quality improvement professionals and survey experts.
A nationally recognized nonprofit organization, IPRO works with government agencies, providers and consumers to implement innovative programs that bring policy ideas to life. For more than 30 years, IPRO has made creative use of clinical expertise, emerging technology and data solutions to make the healthcare system work better.
An ISO-certified organization, IPRO is headquartered in Lake Success, NY, with offices in Albany NY, as well as Connecticut, New Jersey, Pennsylvania, North Carolina, Ohio and California.
For more information, please visit IPRO at ipro.org.