Residency Program Practicum Training: New York State Quality Improvement Organization (IPRO)

IPRO is one of the largest independent quality improvement organizations in the United States, with more than 19 years of continuous utilization and quality review experience on behalf of national and New York-based clients, including review activities for the Medicare and Medicaid programs, unions, and health maintenance organizations. All of IPRO’s projects are based in the health care field, with major emphasis directed toward review activities for the Medicare and Medicaid programs. IPRO also works under separate contracts with other divisions of the State government, such as the Office of Mental Health and the AIDS Institute.

IPRO is responsible for assuring that inpatient services provided are: medically necessary and appropriate; of a quality that meets professionally recognized standards of health care; consistent with the provisions of appropriate medical care; and on an outpatient basis or at a less costly alternative level of available care of services. IPRO examines the patterns of care provided to Medicare and Medicaid patients in New York and the outcomes of that care. This is accomplished through the use of the large databases of the Medicare and Medicaid beneficiaries, as well as other databases. The findings generated by IPRO are shared with hospitals and physicians in a joint effort to help improve the quality of care. This site affords residents instruction and experience in epidemiology and biostatistics, involving analysis of large sets of data; Federal, State, and local medical care policies and regulations; and essential skills, such as communication, leadership, and computer use. While at IPRO a resident has the opportunity to participate in broad surveillance activities involving projects that utilize Medicare, Medicaid, and insurance claims data to examine both the processes and the outcomes of medical care, including the identification of health disparities.