IPRO collaborates with healthcare providers, patients and stakeholders to improve the experiences of New York State Medicare beneficiaries and their families with the healthcare system.
Beneficiary- and Family-Centered Care
Healthcare is personal and each person's experience with the healthcare system is different based on his or her personal preferences and values, family situation, cultural traditions and lifestyle. IPRO and the other Medicare Quality Improvement Organizations (QIOs) strive to promote healthcare that is respectful of and responsive to individual patient preferences, needs and values.
The Beneficiary- and Family-Centered Care initiative focuses on QIO statutorily mandated case review activities as well as on interventions to promote responsiveness to beneficiary and family needs; to provide opportunities for listening to and addressing beneficiary and family concerns; to provide resources for beneficiaries and caregivers in decision making, and to use information gathered from individual experiences to improve Medicare's entire system of health care.
Two of your rights as a Medicare beneficiary are to file a formal complaint about care you have received and to request an appeal when your hospital stay or other medical services are discontinued before you are ready. QIOs like IPRO are here to help you express concerns about your care.
To contact IPRO about a quality of care complaint or concern call:
1-800-331-7767
To contact IPRO about a provider-issued notice of Medicare non-coverage call:
1-888-880-9976 (for questions about HOSPITAL issued notices); or
1-800-833-0356 (if you have Traditional Medicare coverage and have questions about non-hospital provider issued notices); or
1-888-696-9561 (if you are enrolled in a Medicare Health Plan and have questions about non-hospital provider issued notices). For more information, please see the following:
Beneficiary-generated concerns provide an excellent opportunity to explore root causes, to develop alternative approaches to improving care, and to improve beneficiary/family experiences with the health care system. Beneficiary and family engagement and activation efforts are needed to produce the best possible outcomes of care. These QIO beneficiary and family-centered efforts align with the National Quality Strategy, which encourages patient and family engagement by:
- Empowering beneficiaries and their families to be more engaged in healthcare decision-making
- Contributing to safer, more effective care as a result of quality improvement work with local health care providers
- Providing a streamlined process for making and reviewing quality of care complaints
To learn more about IPRO's Patient Empowerment Workshops or other Patient and Family Centered Care initiatives, please call Janice Hidalgo or Andrea Goldstein at 516-209-5364.