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External Quality Review

Improving Medicaid Managed Care quality and performance.

Contact a Kepro Expert

Don’t just meet your quality goals — exceed them

As an External Quality Review Organization (EQRO), Kepro monitors the quality of programs and services provided by your managed care partners. Our team of medical and technical experts analyze volumes of data to identify opportunities to improve the timeliness, quality and access to care. 

We deploy an integrated team of medical and technical experts who analyze data, identifying issues related to timeliness, quality and access to care. This process reveals the nuances of program performance, including its impact on population health. For example, we provide valuable, actionable feedback to plans about their PIP (performance improvement projects)  programs, including an evaluation of project design, validation measures and interventions.

As a result of our comprehensive model, states can meet EQRO requirements while ensuring that members are receiving the highest-quality, most efficient and appropriate care.

Kepro is committed to helping
Medicaid agencies achieve

Improved health outcomes

Accessible, coordinated, high-quality care

Increased member satisfaction


Robust EQRO Capabilities

  • Information system capability assessments
  • Healthcare Effectiveness Data and Information Set (HEDIS) reviews and program analysis
  • Performance measure validation 
  • Performance improvement plan development, implementation and review
  • Ongoing training, education and technical assistance during and after reviews
  • Medical education interventions for facilities, physicians and other providers
  • Comprehensive data collection, analysis and reporting
  • Continuous quality improvement and outcomes management