Overview of MPRO
MPRO is an independent nonprofit organization and a national leader in health care quality improvement and medical review.
Since 1984, MPRO has served as the federally designated quality improvement organization (QIO) for Michigan under contract with the U.S. Centers for Medicare & Medicaid Services. In its role as a QIO, MPRO is charged with the following:
• Improve quality of care for beneficiaries by working with Michigan Medicare providers to embrace evidence-based medicine across all
settings (hospital, physician office, nursing home, and home health);
• Protect the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and
medically necessary and are provided in the most appropriate setting; and
• Protect beneficiaries (approximately 1.5 million beneficiaries in Michigan) by addressing individual complaints, such as beneficiary
complaints and provider-based notice appeals.
In addition, MPRO provides consultative services, medical and utilization review, and data analysis to federal agencies, state Medicaid and public health agencies, healthcare facilities, and private health plans and other third party payers.
Our portfolio of services includes:
- Breast Cancer and Cervical Cancer Control Program (BCCCP)
- External Quality Review (EQR)
- Independent Medical Review
- Informal Dispute Resolution (IDR)
- Long Term Care Remediation
- Medicaid Fee-for-Service Utilization Review Program
Based in Farmington Hills, Michigan, MPRO’s staff consists of physician reviewers, clinical quality improvement and patient safety experts and statisticians. MPRO provides expertise across the continuum including; hospital, nursing home, home health, physician office and managed care settings. Careers at MPRO.
