Business Details
42 Years
experience
Trusted Healthcare Quality Improvement Solutions
Since 1984, IPRO has been dedicated to advancing healthcare quality improvement across the United States. Our organization collaborates with federal and state government agencies, healthcare providers, and communities to ensure healthcare systems are safe, accessible, and equitable. With a team of over 300 professionals and 500 consultantsincluding physicians, nurses, data analysts, and policy expertswe leverage clinical expertise, emerging technology, and data solutions to drive measurable improvements in care. Our work spans nearly 100 state and federal programs in 32 states, focusing on Medicare, Medicaid, and public health initiatives.We maintain rigorous standards through accreditations like URAC certification and prioritize transparency, innovation, and ethical practices in all our projects. By conducting independent reviews, compliance audits, and quality assessments, we help protect healthcare program integrity and improve outcomes for vulnerable populations. Our 40-year legacy reflects a commitment to addressing systemic challenges and fostering collaboration among stakeholders to create a more effective healthcare landscape.
Services
Medicaid Compliance Audit
Independent Review of Appeals
Healthcare Quality Improvement
State Healthcare Assessment
Public Health Emergencies
Pharmacy Quality Services
Medicare Quality Innovation
External Quality Review
Data Analytics Solutions
Clinical Program Evaluation
Details
- Year established: 1984
Highlights and features
- We have 40 years of experience in healthcare quality improvement.
- Our team includes 300+ professionals and 500 consultants across medical and technical fields.
- We operate in 32 states and the District of Columbia.
- We use data analytics and evidence-based practices to drive measurable outcomes.
- Our URAC-certified independent review processes meet federal and state standards.
Associations and certifications
- URAC
Services
Medicaid Compliance Audit
IPRO conducts Medicaid compliance audits to identify fraud, waste, and abuse while recovering improper payments. Our team of auditors, physicians, and legal experts uses data analysis and medical reviews to ensure provider compliance with Medicaid regulations. This service helps states protect program integrity and safeguard taxpayer funds through targeted investigations and recovery strategies.
Independent Review of Appeals
We provide impartial medical necessity reviews for healthcare appeals under federal and state programs. Our board-certified specialists evaluate cases using evidence-based medicine to ensure fair determinations. This service supports compliance with URAC standards and federal regulations while maintaining patient privacy and timely resolution of disputes.
Healthcare Quality Improvement
IPRO develops and implements quality improvement initiatives for Medicare and Medicaid programs. Our experts use clinical data, performance metrics, and stakeholder collaboration to enhance care delivery. This service focuses on reducing disparities, improving patient safety, and aligning healthcare practices with national quality standards through measurable interventions.
State Healthcare Assessment
We conduct comprehensive assessments of state healthcare programs, including maternal and child health initiatives. Our team performs site visits, analyzes data, and develops performance measures to ensure compliance with federal regulations. This service helps states modernize standards, improve service delivery, and achieve better health outcomes for vulnerable populations.
Public Health Emergencies
IPRO supports preparedness and response efforts for public health emergencies. Our experts provide data analysis, policy guidance, and program evaluation to address crises like pandemics or natural disasters. This service helps government agencies implement effective strategies, allocate resources efficiently, and protect community health during critical situations.
People
Allison Xiong
Assistant Vice President
Dr. Xiong leads federal and state healthcare assessment initiatives at IPRO. She chairs the NAIRO Technology/AI/Cybersecurity Committee, focusing on innovative solutions for healthcare quality improvement and data security.
Dana Green Bennett
Vice President
Bennett oversees managed care programs at IPRO, bringing extensive experience in healthcare policy and Medicaid program management to enhance service delivery and stakeholder collaboration.
Debora Santiago
Senior Director
Santiago leads independent dispute resolution efforts at IPRO and chairs the NAIRO Legislative Committee, advocating for policy reforms to improve healthcare quality and access.
Questions
What services does IPRO offer?
IPRO provides Medicaid compliance audits, independent review of appeals, healthcare quality improvement programs, state healthcare assessments, and public health emergency support.
Which states does IPRO serve?
IPRO works in 32 states and the District of Columbia through federal and state government partnerships.
How does IPRO ensure healthcare quality?
We use data analytics, clinical expertise, and evidence-based practices to evaluate and improve healthcare programs while maintaining URAC and federal compliance standards.
What accreditations does IPRO hold?
IPRO is URAC-certified for independent review organizations and meets federal quality improvement network standards.
Videos
Reviews (1)
Ann Jankie
Nov 08, 2016
Report
I don't typically leave reviews but I felt compelled to do so after my extremely disappointing and saddening experience on the phone with Stephanie Rosen, Assistant Director at IPRO. I had been transferred to her after an IPRO associate admitted that he could not answer a few of my questions due to it being his first day on the job. No problem! In being transferred to Stephanie Rosen, I was seeking more information about the process of appealing my mother's hospital discharge to a facility over 2 hours away from my home. I wanted to make sure my appeal emphasized that it was important to find
