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IPRO Builds a Comprehensive, All-Payer Provider Network Data System for New York State

States need timely information about provider networks to identify, assess, and resolve access problems and ensure network adequacy. Most face fragmented data streams and labor-intensive data culling to know which providers are available to consumers by specialty, location, language, and other key characteristics. Consumers, too, have trouble finding primary and specialty services near home, some times having to make multiple calls before they find a provider in their network accepting new patients. In 2013, the New York State (NYS) Department of Health selected IPRO to architect a Provider Network Data System (PNDS), the first ever, comprehensive, all-payer provider network in the nation. IPRO was charged with development of a solution that would collect and integrate a comprehensive range of provider network data variables for most types of health plans including HIV Special Needs Plans, Family Health Plus Buy-In Programs, Programs of All-Inclusive Care for the Elderly (PACE), and non-PACE Managed Long Term Care (MLTC). It further included all licensed providers and facilities including physicians, nursing homes, hospitals, laboratories, and home health agencies.

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