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Published
Article on Peer Review
CIMRO’s Medical
Director, Barry Slotky, MD and Project Manager, Judy Kinkelaar Ring, RN,
BSN recently coauthored an article, Independent Review Supports
Transparency that was published in ABQAURP’s Patient Safety
& Quality Healthcare Journal. Click here
for a link to the article.
CIMRO Awarded Independent Peer Review Contract with LifePoint Hospitals, Inc.
Spring 2008 - CIMRO recently signed a contract with LifePoint Hospitals, Inc. to provide independent peer review services to LifePoint facilities. LifePoint Hospitals, Inc. is one of the nation's largest hospital companies focused on non-urban healthcare, with 48 general acute care hospitals in 17 states. Throughout its history, LifePoint’s sole mission has been to develop strong community-based hospitals in non-urban markets.
Cases are selected by each LifePoint facility and forwarded to CIMRO, where reviews are conducted by board certified physicians who match the specialty of the care under review. CIMRO physician reviewers provide an unbiased opinion regarding the care rendered, which is based on documentation in the medical record.
CIMRO Awarded Strategic Service Partner Contract from QHR
CIMRO became a QHR Strategic Service
Partner in June 2007 . QHR is a Family of Brands that has provided consulting, management and education resources to hospitals and health systems for three decades. QHR is the dominant market leader in hospital management resources, with nearly 200 current multi-year clients in 39 states across the U.S.
QHR’s Strategic Service Partner (SSP) Program provides its hospital clients with access to specialized services. An SSP must undergo a stringent identification and selection process to ensure its vision and values are compatible with QHR and that its products or services offer clients high quality and great value. SSPs must demonstrate:
 A proven track record;
Consistently strong financial performance;
A demonstrated commitment to business ethics; and
A national or regional presence to support all QHR hospital clients.
CIMRO provides independent peer review to assist facilities with their internal QI activities to mitigate conflict of interest concerns (e.g., practitioners in direct competition or within the same practice, too few practitioners in a specialty, etc.) when an unbiased review by a peer is not possible; ensure adherence to quality standards; reduce liability risk; and meet regulatory, credentialing, and accreditation requirements.
Services include the full range of review/oversight activities, including sentinel/adverse event reviews, mortality reviews, medical imaging/diagnostic and interventional cardiology/sleep study overreads, antibiogram reviews, pattern of care reviews, experimental/investigational determinations, fair hearing expertise, peer review-related education, and Critical Access Hospital oversight and monitoring.
Independent Peer Review Contracts
As noted on the map below, CIMRO performs independent review services in
35 states. Independent peer review is requested by clients for periodic review and receipt of an objective opinion on the quality of medical services rendered by providers. Patient-specific records and current standards of practice for the diagnosis and treatment involved are utilized in making a determination. National clinical guidelines and peer-reviewed literature are also considered in the reviewer’s decision-making process. CIMRO provides a detailed report to the client regarding the findings of each case within 30 calendar days of the request. Expedited reviews may be conducted upon request. Additionally, we provide such services as onsite or telephonic educational sessions and peer-to-peer discussion, specialty reviews (patterns of care, antibiogram, mortality, etc.), and we participate in onsite fair hearings, when requested. CIMRO has
nearly 700 credentialed peer reviewers in every major specialty and sub-specialty available to conduct independent peer review.
CIMRO Awarded Critical Access Hospital Quality Oversight Contract
CIMRO was awarded a quality oversight contract with a Missouri Critical Access Hospital to assist the CAH in meeting Federal Conditions of Participation. As part of the contract CIMRO reviews the CAH’s policies and procedures related to patient care, evaluates the CAH’s quality improvement program and plan and makes recommendations for improvement, reviews a sample of medical records for validation of documentation requirements, and conducts onsite visits to the
CAH, interviewing staff, observing daily hospital activities, and verifying the CAH's compliance with its policies and Federal and State regulations.
CIMRO Receives URAC Re-accreditation
CIMRO, a not-for-profit health care utilization management/quality improvement organization with nearly
37 years of medical management experience, announced that it was awarded its Health Utilization Management reaccreditation by
URAC, a Washington, DC-based health care accrediting organization that establishes quality standards for the health care industry.
URAC accreditation is a rigorous process and establishes CIMRO as an organization that has the necessary infrastructure and processes to promote high quality health care. It also demonstrates CIMRO’s willingness to be measured against nationally accepted benchmarks. CIMRO has been accredited by URAC since 1999.
"CIMRO is honored to receive Health Utilization Management accreditation from
URAC," said Tina Georgy, CEO of CIMRO. "We are very pleased to be recognized in the industry for providing outstanding services. Such a distinction also underscores the quality of our work with clients by demonstrating compliance with national standards for utilization management and quality improvement services."
“By applying for and receiving URAC accreditation, CIMRO has demonstrated a commitment to quality health care,” said Charles Stellar,
then URAC Board Chair. “Quality health care is crucial to our nation’s welfare and it is important to have organizations that are willing to measure themselves against national standards.”
URAC, an independent, nonprofit organization, is a leader in promoting health care quality through accreditation and certification programs. URAC's standards keep pace with the rapid changes in the health care system and provide a mark of distinction for health care organizations to demonstrate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in setting meaningful standards for the health care industry. For more information, visit
www.urac.org.
CIMRO assists health care organizations in 35 states with accreditation/regulatory, quality improvement, and credentialing activities. Hospitals and other health care facilities seek CIMRO’s peer review services in order to support their internal quality activities.
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