IFMC to Manage the Oklahoma Medicaid External Quality Review Program

WEST DES MOINES, Iowa, July 8, 2011 /PRNewswire/ -- The Oklahoma Health Care Authority has selected IFMC to operate the SoonerCare External Quality Review Program.  The contract with IFMC began July 1, 2011. This new contract expands IFMC's work with the Oklahoma Health Care Authority which began in 2007 when IFMC was selected to operate the SoonerCare Health Management Program.

The new External Quality Review program includes several major components:

• Retrospective Utilization Review - IFMC will conduct reviews for selected inpatient and outpatient medical services provided to SoonerCare members.  These reviews will be performed to determine if the services were medically necessary and met professional standards for the quality of care.
• Quality Interventions & Education - IFMC will work with selected medical providers to help them improve the quality of care delivered to their patients.
• QISMC – IFMC will monitor and assess the effectiveness and efficiency of care provided to the SoonerCare Choice population.
• Quality Assessment & Performance Improvement – IFMC will complete seven QAPI projects each year.
• Member Satisfaction Surveys – IFMC will measure member satisfaction with the SoonerCare program each year to assist the Health Care Authority in improving the delivery of care.
• HEDIS Measures – IFMC will measure provider performance using standard quality metrics included in the HEDIS measure set.  

Support for this new contract will be provided by nurses and other health care professionals operating from IFMC's existing office in Oklahoma City.  "We are looking forward to expanding our relationship with the Health Care Authority," says Mike Speight, Senior Director at IFMC.  "We have experience operating similar programs in other states and are eager to make a difference in the lives of Oklahoma residents."

IFMC is an experienced, national leader with significant expertise in utilization management, quality improvement, and working with state Medicaid programs.  

For more than 35 years, IFMC has been dedicated to the delivery of innovative health management solutions focused on improving the quality, service and cost of health care. IFMC serves commercial clients and government programs at the federal, state and local level. Our employees make a difference in the improvement of health care for millions of people nationwide. IFMC has offices in New York, Illinois, Maryland, Minnesota and Oklahoma and is headquartered in Iowa.

SOURCE IFMC