IPRO QIO Uses Milliman Care Guidelines(R) for Medicare Reviews in New York State

SEATTLE, March 5 /PRNewswire/ — IPRO, one of the nation’s leading Quality Improvement Organizations (QIOs), has signed a five-year licensing agreement with Milliman Care Guidelines, LLC, A Milliman Company, to use the Care Guidelines for Medicare utilization and quality reviews in the state of New York.

IPRO will use all Care Guidelines products — Ambulatory Care, Inpatient and Surgical Care, General Recovery Guidelines, Recovery Facility Care, Home Care, Chronic Care Guidelines and Behavioral Health Guidelines — through Web software to support appropriate quality of clinical care for Medicare beneficiaries.

The Centers for Medicare & Medicaid Services (CMS) contracts with QIOs in each state to conduct Medicare reviews and quality initiatives across a variety of healthcare settings. It does not mandate or endorse the use of any specific criteria set by QIOs.

The Care Guidelines promote quality care by providing healthcare professionals with access to best practice based on annually updated evidence. The Care Guidelines also display Quality Measures approved by CMS, and each inpatient topic includes care planning information highlighting interventions that lead to improved outcomes. Designed for prospective, concurrent, and retrospective reviews, the Care Guidelines enable informed and consistent clinical care decisions, and support the best possible care management using the most current evidence-based medicine.

“The Care Guidelines incorporate CMS Hospital Quality Initiative Core Measures,” said Scott Harris, Milliman Care Guidelines Senior Vice President of Sales and Marketing. “Access to evidence-based clinical tools that improve quality of care enables QIOs to effectively manage their review processes and quality initiatives.”

About IPRO

Incorporated as an independent not-for-profit organization in 1983, IPRO (www.ipro.org) is one of the largest and most experienced healthcare quality review and improvement organizations in the nation. With annual revenues of more than $50 million, IPRO’s clients include federal and state governments as well as municipalities. IPRO’s affiliate, Logiqual (www.logiqual.com), conducts quality-of-care audits on behalf of individual managed care plans.

About Milliman Care Guidelines

Milliman Care Guidelines LLC, A Milliman Company, is located in Seattle, and independently develops and produces evidence-based clinical guidelines and a variety of software options that are used by more than 1,000 clients nationally and support the care of almost two-thirds of US health plan members. Covering the continuum of care, the seven-product Care Guidelines series is updated annually by an experienced team of clinicians. For more information, visit www.careguidelines.com.

About Milliman

Milliman Care Guidelines is a wholly owned subsidiary of Milliman, Inc., which is among the world’s largest independent actuarial and consulting firms. Founded in Seattle in 1947 as Milliman & Robertson, the company now has 49 offices in key locations worldwide. Milliman employs more than 2,000 people, with a professional staff of more than 1,000 qualified consultants and actuaries, including specialists ranging from clinicians to economists. The firm has consulting practices in healthcare, employee benefits, property and casualty insurance, life insurance and financial services. Milliman serves the full spectrum of business, financial, government, union, education and nonprofit organizations. For more information, visit www.milliman.com.

SOURCE Milliman Care Guidelines