With a focus on constant improvement, Metropolitan has established a "Partners in Quality" (PIQ) program designed to measure and reward its network of caregivers based on criteria such as increased patient satisfaction, patient quality of life metrics, and excellence in medical record keeping and review, thereby increasing quality and efficiencies at all levels of the healthcare delivery chain. Metropolitan has substantial expertise in disease management, quality assurance, utilization management, as well as claims adjudication and payment, allowing the company to provide turnkey services to HMOs' on a full risk basis. Metropolitan's commitment to service allows their HMO clients to focus resources on increasing their base of patient lives managed without compromising quality or profitability to their patients or organization respectively.