Executive Committee

The Executive Committee is responsible for managing the affairs of the corporation on behalf of the Board and under the direction and authority of the Board. At the meetings of the Board, the committee apprises the Board of the affairs of the corporation. It seeks and nominates qualified candidates for election as officers and directors of the corporation in the event a vacancy in such positions has been declared or is anticipated. The president of the Board of Directors serves as the chairman of this Committee. The Legislative Liaison’s responsibility is limited to maintaining knowledge regarding the issues impacting the Mesa County Physicians IPA, Inc. (MCPIPA) which occur in the legislative or political bodies, and updating the committee on such issues at one of its regular meeting on a quarterly basis.

Clinical Integration Committee

The Clinical Integration Committee was created in September 2010 to evaluate the possibility of creating a Clinical Integration Program for MCPIPA in compliance with the Consent Order between MCPIPA and the Federal Trade Commission (FTC).  They formulated and implemented a plan with approval of the MCPIPA Board of Directors on how to achieve Clinical Integration. During 2011, this committee worked on the creation of the programs and assisted in compilation of the documents necessary for the communication between the FTC and MCPIPA. Going forward this committee will continue work on managing the program; including designing potential contracts with payers, self-insured employer groups and others who could benefit from our Clinical Integration Program.  They will also perform any other work necessary to assist MCPIPA with Clinical Integration under the direction of the Board of Directors and Executive Committee. 

Medical Practice Review Committee

This Medical Practice Review Committee (MPRC) of the Mesa County Physicians IPA, Inc. is responsible for the review and evaluation of the quality of medical or other health care services and the utilization of medical or other health care services in conjunction with any health plan for which the IPA has agreed to provide the services of physicians and other health care professionals. This Committee is authorized to act as a professional review committee under the provisions of state and federal laws.  It operates under the terms of state(1) and federal laws(2), the bylaws of MCPIPA, and the quality improvement policies and procedures of the applicable health plan.

(1) Colorado Statute Section 12-36.5-101 et seq.

(2) The Healthcare Quality Improvement Act of 1986, 42 U.S.C. 11101-11152

Physician Incentive and Engagement Committee

The Physician Incentive and Engagement Committee (PIEC) is responsible to design, facilitate and monitor programs relating to payments to Members under the terms of incentive plans.  This Committee will receive approval of such plans, programs, fees and charges of participating health care providers from the Board and any other applicable committee established under the Bylaws or pursuant to resolution of the Board. Absent the appointment of a Physicians Reimbursement Committee, the review and approval of schedule of fees and charges, and other matters pertinent thereto will be undertaken by the Board.

Quality, Value, and Outcomes Committee

The Quality Value and Outcomes Committee (QVOC) is responsible to: 

1. Develop clinical quality and utilization review programs, steps to implement such programs, and plans to monitor the outcomes of such programs;
2. Set overall utilization review and management priorities;
3. Design clinical care guidelines and provide ongoning oversight, review and modification of such guidelines;
4. As deemed appropriate by the committee or the Board, generate general financial and analytical reports regarding utilization of medical service, based on historical claim data, for the purpose of measuring historical claims data, for the purpose of measuring results of, or necessity for, utilization programs or guidelines;
5. Perform any other tasks assigned to it by the Board;
6. Present all program, guidelines, and priorities to the Board for approval;
7. Report regularly to the Board, and communicate to the Board upon request.

Task Forces: In order to effectively accomplish its duties, it may become necessary from time to time for the QVOC to involve individuals outside of the committee.  To do so, the QVOC may form one or more “task forces,” comprised of Members or employees of the corporation or other individuals.  The QVOC appoints and removes members of such task forces.  The task forces are formed for a specified duration of time, are charged with specific goals and objectives, and report to the QVOC as requested by the same.  Membership in a task force does not create membership in the QVOC, any other committee of the corporation or in the corporation, and does not otherwise form an agency relationship between the member of the task force and the corporation.  Information on the current task forces is summarized below.

Advanced Imaging Task Force

Mission: To continue to manage the appropriate use of advanced imaging and relieve IPA members from the obligation to preauthorize imaging studies.

Traumatic Brain Injury Task Force

Mission: To help educate the community regarding impact, recognition, assessment, intervention, and follow-up of concussion and traumatic brain injury.

Emergency Room Task Force

Mission:  To achieve the goals listed below, this task force is challenged to improve the state fee-for-service Medicaid utilization rates of patients treated by IPA members, as compared to MCPIPA members’ previous years’ utilization rates.

Primary Care Incentive Design Task Force

Mission:  To determine how Primary Care Physicians can earn their incentive compensation under pay for performance programs.

Specialty Design Incentive Design Task Force

Mission:  To determine how Specialist physicians can earn their incentive compensation under pay for performance programs.