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Quality Management Program

What you need to know

Our Quality Management (QM) program supports the Health Partners Plans commitment to provide quality care and service to our members.

It involves the entire company and includes:

  • Making sure information goes through our committees for review
  • Reporting information on how we are doing to state and other agencies
  • Coordinating NCQA accreditation to measure plan quality

The program reviews a wide range of areas, including:

  • Our provider network (assuring it meets quality, access and availability standards)
  • Member and provider satisfaction
  • Patient safety and related information
  • Member complaints and grievances
  • Our Baby Partners and Fit Kids programs, and disease management programs for members with diabetes, congestive heart failure and asthma

The program also directly improves the health of our members by:

  • Providing health education
  • Offering extra help where needed to achieve better results, including addressing language needs and cultural differences
  • Making sure our members get the care they need, using checkup reminders, newsletters and other mailings, and phone calls
  • Using community events to take health information and screenings to members where they live, including members of diverse communities

For more information about our QM program, please contact our Quality Management department at 215-991-4346.