IPRO
IPRO is a national non-profit healthcare quality improvement organization serving CMS, 21+ state health departments, 150+ managed care plans, and providers across 32 states via QIN-QIO contracts, four ESRD Networks, EQRO services, and certified IDR work.
- Company typePrivate
- Founded1984
- HeadquartersNew Hyde Park, United States
- Headcount251–500
- GTM typeB2B
- OfferingServices
What IPRO does
IPRO is a national, not-for-profit healthcare quality improvement organization incorporated in 1983 and operational since 1984. Headquartered in Jericho, New York, with regional offices in Albany (NY) and Hamilton (NJ), IPRO employs more than 300 full-time professionals and maintains a network of 500+ board-certified physician consultants and subject-matter specialists spanning epidemiology, biostatistics, health informatics, pharmacy, nursing, coding, and quality improvement. The organization operates across nearly 100 state and federal programs in 32 states plus the District of Columbia, serving CMS, state departments of health, managed care plans, healthcare providers, and consumers.
The company's core offerings are organized around federally and state-mandated quality oversight. IPRO is the designated CMS Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for both Region 1 (Northeast) and Region 2 (Mid-Atlantic) under the 13th Statement of Work, with contracts running through May 2030 and covering 24% of the nation's Medicare beneficiaries. It operates four End-Stage Renal Disease (ESRD) Networks supporting approximately 60,000+ dialysis patients and 900+ Medicare-certified facilities. IPRO serves as an External Quality Review Organization (EQRO) for Medicaid managed care in 21+ states, working with more than 150 managed care plans, and is a certified Independent Dispute Resolution Entity under the No Surprises Act. Supporting technology includes an in-house software development team maintaining encounter data warehouses for multiple states, the Kidney Transplant Compare mobile application, and quality measurement and reporting systems. Strategic content assets include the Quality Watch Podcast, Healthy Insights Newsletter, IPRO-authored scholarly articles, and Project Firstline infection prevention training delivered to approximately 165,000 healthcare workers.
IPRO's revenue model is entirely contract-based and government-anchored. Primary streams are federal contracts with CMS (QIN-QIO, ESRD Networks, IDR) and state Medicaid contracts (EQRO, compliance audits, utilization review, state-directed payment assessments, state healthcare assessments). Provider-facing technical assistance and consulting engagements constitute a smaller, supplementary stream. As a 501(c)(3)-style non-profit, IPRO has no equity shareholders, no public ticker, and does not disclose revenue; pricing is set through federal and state procurement processes rather than published rates. The organization reinvests contract revenue into program delivery, content production, workforce, and SOC 2 Type 2 / HIPAA-compliant infrastructure.
IPRO firmographics
Firmographics- Name
- IPRO
- Legal name
- IPRO
- Website
- https://ipro.org
- Company type
- Private
- Founded year
- 1984
- Operating status
- Operating
- Headcount range
- 251–500 employees
- Short description
- IPRO is a national non-profit healthcare quality improvement organization serving CMS, 21+ state health departments, 150+ managed care plans, and providers across 32 states via QIN-QIO contracts, four ESRD Networks, EQRO services, and certified IDR work.
- Ownership category
- akta.pro rank
Where IPRO is headquartered
LocationHeadquarters
- HQ city
- New Hyde Park
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
IPRO business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Federal Government Contracts: IPRO generates primary revenue through federal contracts with CMS for QIN-QIO programs (Regions 1 and 2 through 2030), ESRD Network Programs, and other healthcare quality improvement initiatives. Contract terms run through May 2030.
- State Government Contracts: Revenue from state departments of health for Medicaid EQRO services, state healthcare assessments, compliance audits, and other quality improvement programs across 21+ states.
- External Quality Review Organization (EQRO): IPRO serves as EQRO for multiple states, evaluating quality of healthcare services provided to Medicaid Managed Care enrollees, generating revenue through contractual arrangements with state Medicaid programs.
- Healthcare Quality Improvement Consulting: IPRO provides consulting services to healthcare providers, including technical assistance, training programs, and quality improvement consultation for nursing homes, hospitals, and outpatient clinical practices.
Go-to-market motion3 records
Distribution channels4 records
Marketing channels7 records
IPRO product offering
Product offeringCore offering
IPRO is a non-profit healthcare quality improvement organization that delivers contracted services to federal and state governments, healthcare providers, and managed care plans. Its core offerings include the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) program for CMS Regions 1 and 2, ESRD Network Programs for End-Stage Renal Disease patients, External Quality Review Organization (EQRO) services for state Medicaid programs, Independent Dispute Resolution under the No Surprises Act, Independent Review of Appeals, and supporting digital tools such as the Kidney Transplant Compare mobile application.
Product overview
IPRO is a healthcare quality improvement organization that operates as a platform of interconnected programs and services designed to improve healthcare outcomes across various populations. The core offerings include federal quality improvement contracts (QIN-QIO, ESRD programs, EQRO services) that provide regulatory compliance and performance improvement support, along with dispute resolution services (Independent Review of Appeals, IDR). Supporting these core services are digital tools including the Kidney Transplant Compare mobile application and content resources such as the Quality Watch Podcast and Healthy Insights Newsletter. The organization functions as both a direct service provider and an advisory/educational resource for healthcare stakeholders including CMS, state health departments, providers, and patients.
Differentiator
Problem solved
Functional benefit
Brands
- Kidney Transplant Compare: Mobile application and website that empowers kidney patients to find transplant centers by providing comparative data on programs, allowing users to filter by location, medical selection criteria, outcomes, and support services.
- Quality Watch Podcast
- Healthy Insights Newsletter
Products and services
- Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO)
Quantifiable outcome
- 24% of nation's Medicare beneficiaries served through QIN-QIO programs
- +3 more outcomes
Companies that use IPRO
Customer profileNamed customers5 records
Segments5 records
Ideal customer profiles4 records
IPRO technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature6 records
IPRO partnerships and signals
Strategic signalPartnerships
14 partnerships are on record, tiered core, flagship and minor.
- Healthcentric AdvisorscoreHealthcentric Advisors, based in Rhode Island, serves as a subcontractor to IPRO under the CMS QIN-QIO contract for Region 1 (Northeast). Together with IPRO and Qlarant, they form a collaboration of three organizations with decades of experience serving as Medicare QIOs, providing direct technical assistance, advanced data analytics, evidence-based intervention recommendations, and customized training to healthcare providers.
- QlarantcoreQlarant, based in Maryland, serves as a subcontractor to IPRO under the CMS QIN-QIO contract for Region 1 (Northeast). Together with IPRO and Healthcentric Advisors, they form a collaboration providing multidisciplinary teams of experienced healthcare quality improvement specialists for direct technical assistance and resources to nursing homes, hospitals, and outpatient practices.
- New York State Department of HealthcoreIPRO was selected by New York State to implement Project Firstline, a CDC-led project bringing critical infection prevention and control training to frontline healthcare staff in NYS dialysis centers. The project is sponsored by Health Research Inc. (HRI) which administers funding for NYSDOH public health goals.
- Health Research Inc. (HRI)coreHealth Research Inc. (HRI) administers funding to further public health goals of the NYS Department of Health and other entities. HRI sponsors Project Firstline, the CDC-led infection prevention training program implemented by IPRO in New York State dialysis centers.
- Centers for Disease Control and Prevention (CDC)coreCDC leads Project Firstline, an initiative that has developed more than 900 educational products and training materials and hosted more than 2,400 educational events reaching approximately 165,000 healthcare workers as of December 2023. IPRO implements this program in New York State dialysis centers.
- Centers for Medicare & Medicaid Services (CMS)flagshipCMS awarded IPRO contracts to serve as the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for both the Northeast (Region 1) and Mid-Atlantic (Region 2) under the 13th Statement of Work. Contracts run through May 2030 and cover 24% of the nation's Medicare beneficiaries.
- Yale New Haven Health Services Corporation/Center for Outcomes Research and Evaluation (CORE)coreIPRO Senior Director Mary Dramitinos participates on a Technical Expert Panel for Medicaid Total Cost of Care measure development, which CORE is developing with CMS. The TEP provides guidance on measure design, methodology, and implementation considerations.
- Chronic Kidney Disease ChampionsminorPatient advocacy group that provided direct input into the development of Kidney Transplant Compare application, ensuring the 131 data points included reflect information most important to patients.
- Health Literacy Media (HLM)coreHLM leads the Public Education for the Living Organ Donation Reimbursement Program (LODRP) funded by HRSA. IPRO Director Caroline Sanner serves on the Advisory Board supporting this project's goal to increase awareness and equitable access to living organ donation reimbursement, particularly among medically underserved communities.
- National Kidney FoundationcorePartner in the Public Education for the Living Organ Donation Reimbursement Program (LODRP) alongside Health Literacy Media and Houston Methodist Hospital, working to increase awareness of and access to living organ donation financial support.
- Houston Methodist HospitalcorePartner in the Public Education for the Living Organ Donation Reimbursement Program (LODRP) alongside Health Literacy Media and National Kidney Foundation, contributing to outreach and education initiatives for living organ donation.
- National Association of Independent Review Organizations (NAIRO)minorIndustry trade association dedicated to upholding integrity of medical peer review and utilization review processes. IPRO's Allison Xiong, Ph.D. serves as Chair of the Technology/AI/Cybersecurity Committee, engaging in monthly meetings with industry experts to discuss latest developments in AI and emerging technologies.
- National Association of Independent Review Organizations (NAIRO)minorIPRO's Debora Santiago serves as Chair of NAIRO's Legislative Committee, attending monthly meetings to provide members with updates on trends and pending legislation. IPRO contributes to safeguarding important review processes through this industry association.
- Partnership for Quality MeasurementcoreConsensus-based entity certified by CMS to bring together experts in healthcare quality improvement to endorse quality measures. Multiple IPRO employees serve on Pre-Rulemaking Measure Review (PRMR) committees including Hospital, Clinician, and Post-Acute Care & Long-Term Care Advisory Groups.
Scale indicators10 records
Recent moves6 records
Expansion highlights5 records
IPRO competitors and assessment
Company assessmentEmerging players
- IMPAQ International: IMPAQ International is a research and analytics firm that performs healthcare quality measurement, program evaluation, and policy analysis for federal agencies. It competes with IPRO for healthcare QI contracts but operates as a for-profit with broader international policy work.
Direct peers
- MetaStar: MetaStar is a Wisconsin-based non-profit QIO providing healthcare quality improvement, EQRO, and utilization review services to state Medicaid agencies and CMS. It is comparable to IPRO in scope, customer base (state Medicaid programs), and contract-based delivery model.
- Stratis Health: Stratis Health is a Minnesota-based non-profit QIO focused on improving healthcare quality in the Upper Midwest. It is a direct peer in CMS QIN-QIO and EQRO services with comparable customer base and contract-driven business model.
- Qlarant: Qlarant is a Maryland-based non-profit QIO that serves as IPRO's subcontractor on the Region 1 QIN-QIO contract. It provides comparable healthcare quality improvement, case review, and EQRO services to federal and state clients across multiple US regions.
- Telligen: Telligen is a non-profit healthcare quality improvement organization serving as a CMS QIN-QIO and ESRD Network operator in multiple US regions. It competes with IPRO in federal healthcare QI procurements and offers comparable population health and quality measurement services.
- Healthcentric Advisors: Healthcentric Advisors is a Rhode Island-based non-profit QIO that partners with IPRO on the Region 1 QIN-QIO contract. It offers directly comparable Medicare quality improvement, patient safety, and clinical analytics services with similar customer segments and contract structure.
- Alliant Health Solutions: Alliant Health Solutions (formerly Georgia Medical Care Foundation) is a non-profit QIO serving as a CMS QIN-QIO contractor across multiple southeastern states. It directly competes with IPRO in federal quality improvement procurements and operates an ESRD Network.
- Health Services Advisory Group (HSAG): HSAG is one of the largest US non-profit QIOs, serving as a QIN-QIO and EQRO contractor across multiple western and southwestern states. It is a direct competitor to IPRO in federal and state healthcare quality improvement procurements with comparable services.
Broad incumbents
- Centers for Medicare & Medicaid Services (CMS): CMS is the federal agency that funds and oversees IPRO's largest contracts (QIN-QIO, ESRD Networks). While not a commercial competitor, CMS shapes the regulatory environment IPRO operates within and represents the dominant counterparty in IPRO's revenue model.
- Mathematica: Mathematica is a major US policy research and data analytics firm that performs healthcare quality measurement, program evaluation, and CMS technical assistance work. It is comparable to IPRO in healthcare analytics and federal government contracts but operates more broadly across policy areas.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
IPRO social profiles
Digital presenceIPRO compliance and trust
Trust signalCompliance3 records
IPRO financial estimates
Financial estimateRevenue estimate
Valuation estimate
IPRO leadership team
Management profileNumber of profiles
Profiles13 records
IPRO subsidiaries and ownership
Company hierarchySubsidiaries4 records
IPRO funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
IPRO M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about IPRO
What does IPRO do?
IPRO is a non-profit healthcare quality improvement organization that delivers contracted services to federal and state governments, healthcare providers, and managed care plans. Its core offerings include the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) program for CMS Regions 1 and 2, ESRD Network Programs for End-Stage Renal Disease patients, External Quality Review Organization (EQRO) services for state Medicaid programs, Independent Dispute Resolution under the No Surprises Act, Independent Review of Appeals, and supporting digital tools such as the Kidney Transplant Compare mobile application.
Is IPRO a public or private company?
IPRO is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was IPRO founded?
IPRO was founded in 1984. It employs 251 to 500 people.
Where is IPRO based?
IPRO is headquartered in New Hyde Park, United States, in the North America region.
How does IPRO make money?
Four revenue lines are on record. Federal Government Contracts are the primary driver. The others are state Government Contracts, external Quality Review Organization (EQRO) and healthcare Quality Improvement Consulting.
Who are IPRO's main competitors?
IMPAQ International is listed as an emerging player. Direct peers are MetaStar, Stratis Health, Qlarant, Telligen, Healthcentric Advisors, Alliant Health Solutions and Health Services Advisory Group (HSAG). Broad incumbents are Centers for Medicare & Medicaid Services (CMS) and Mathematica.
Does IPRO have an API?
No public API is recorded for IPRO.