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Quality Management Program Goals for 2019

Click on the links below to view quality management resources, including the 2018 member satisfaction survey, our 2019 quality management goals and the 2018 Healthcare Effectiveness Data and Information Set (HEDIS) rates summary.

Quality Management Program Goals

Our Quality Management program is designed to ensure that members receive safe and effective clinical care that is timely and patient centered. Throughout the year, Health Partners Plans (HPP) monitors the delivery of health care to our members and annually evaluates the program to determine if goals were met and define goals for the year ahead.

A sample of HPP’s 2018 accomplishments includes:

  • HPP was awarded an accreditation status of Excellent by the National Committee for Quality Assurance (NCQA) and NCQA Multicultural Health Care recognition
  • Implementation of the National Diabetes Prevention Program (DPP), a lifestyle change program to prevent type 2 diabetes in prediabetic members
  • Placement of a licensed social worker and registered nurse at two sites to promote early identification of members at risk for ambulatory sensitive conditions that may be caused by homelessness
  • Completion of 966 integrated care plans for members with Severe Persistent Mental Illness (SPMI)
  • Expansion of the Patient-Centered Medical Home (PCMH) program to include 13 high-volume adult and pediatric practice groups, representing a total of 105,220 HPP members
  • Continuation of ongoing provider monitoring to address quality of care issues and complaints, particularly through the addition of the Provider 360 tool, which assesses individual network provider performance

HPP’s Quality Management goals for 2019 and specific objectives include:

  • Improve health outcomes through greater access to quality care
  • Improve member satisfaction with the plan and provider services
  • Improve health management rates
  • Working together with  behavioral health services to improve member outcomes
  • Assemble a multidisciplinary work group for the Centers of Excellence to coordinate care and participate in regional/statewide learning networks
  • Ensure member complaints and quality of care cases are opened and processed within specified time frames
  • Address members’ needs from a cultural and linguistic perspective; continue after-visit member surveys to understand barriers to member’s satisfaction with their provider
  • Continue to review prescription drug claims and opioid utilization monitoring to improve patient safety and cost effectiveness

For more information

For more details about all of HPP’s accomplishments, please call our Quality Management Department at 215-991-4202.