Executive Overview
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Theodore O. Will, Chief Executive Officer, and Donald Winikoff, MD, President
IPRO is a national organization providing a full spectrum of healthcare assessment and improvement services that foster more efficient use of resources and enhance quality. Now celebrating our 27th Anniversary, our organization’s 450 employees provide services in more than 30 states, accounting for annual revenues in excess of $60 million.
While maintaining a leadership role in New York as the state's Medicare-funded Quality Improvement Organization (QIO) and Medicaid-funded utilization management contractor, we have significantly expanded our portfolio of activities. As a regional Medicaid Integrity Contractor, we audit claims to identify potential overpayments in Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New York, New Jersey, Puerto Rico and the Virgin Islands. We are in the midst of a Knowledge Transfer/Implementation contract awarded by the U.S. Agency for Healthcare Research and Quality and recently completed a special project from the Centers for Medicare & Medicaid Services (CMS), to support the integration of hospices into the overall health system and to test first-generation hospice quality measures.
In February 2011, we learned that our Medicare QIO contract would be automatically renewed for the three-year period beginning August 1, 2011. This recognition as a high-performing organization is particularly gratifying, inasmuch as we were one of only two QIOs in the nation to have been assigned all three special projects awarded selectively in addition to the core work of the “Ninth Scope of Work.” The core themes were beneficiary protection, patient safety and prevention, while the three “sub-national” themes addressed care transitions, prevention disparities and chronic kidney disease prevention.
We have retained and expanded upon our End-Stage Renal Disease Network oversight contract; in addition to monitoring providers in New York State, we now provide technical support to all ESRD Network contractors nationwide, while playing a leadership role in support of CMS’s national “Fistula First” initiative. Our expanding responsibilities in this area required us recently to open a new satellite office in Raleigh, North Carolina. In terms of our state work, we recently renewed a critical Early Intervention monitoring contract in New York, whereby we oversee providers serving developmentally disabled children under age three and their families. We now conduct independent external reviews of coverage appeals lodged by consumers in 17 states and the District of Columbia. Additionally, we provide oversight to Medicaid-funded managed care plans on behalf of state governments in New York, Kentucky, and Nebraska.
Our expanding eServices group has pioneered the development of innovative websites that analyze performance data with the goal of promoting transparency and stimulating quality improvement. Clients include The Commonwealth Fund and its groundbreaking “Why Not the Best” website, The Illinois Department of Public Health and the nationally-recognized Bridges to Excellence program.
As our nation embarks on the difficult effort to implement a challenging set of health reform provisions, we will no doubt face a number of challenges. But as an organization with a track record of innovation, we are certain that IPRO’s dedicated staff will be able to sustain our mission and embrace these new challenges.
Representative Recent Clients/Contracts
Printed on Saturday 04th 2012f February 2012 01:08:04 PM
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