Quality Improvement Program


The Quality Improvement Program:

  • Checks providers to be sure you have access to a qualified health care team.
  • Reviews and takes action when there is an issue with the quality of care that has been provided.
  • Promotes safety in health care through education for our members and our providers.
  • Provides a Grow and Stay Healthy Guide to help members know what services are needed and when.
  • Provides a Guide to Accessing Quality Health Care to help members access our programs and services.
  • Evaluates the quality of health care through HEDIS® (Healthcare Effectiveness Data and Information Set).
    • These scores tell us when you have received the type of care you need. The scores look at how often members receive services such as flu shots, immunizations, eye tests, cholesterol tests and prenatal care for members who are pregnant.
    • Check out our HEDIS® rates and results.
  • Surveys members’ satisfaction with care. One type of survey is called CAHPS® (Consumer Assessment of Healthcare Providers and Systems).
    • This tells us if you are happy with your care and your provider. It also tells us what we can make better for our members. Some things are getting the right type of appointment at the right time and having enough providers to take care of your needs.
    • Check out our CAHPS® results.

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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).