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Quality Management Resources

Our Quality Management (QM) program supports HPP's commitment to provide quality care and service to our members.

Our QM program 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

Overview

QM 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, as well as our disease management programs for members with diabetes, congestive heart failure and asthma

QM 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 direct outreach
  • Using community events to take health information and screenings to members where they live, including members of diverse communities

Goals and Accomplishments

Each year, the QM program monitors the delivery of health care to members and annually evaluates the entire program to determine if goals were met and define goals for the year ahead. We publish our HEDIS rates, goals and our accomplishments annually. Click here to view the latest HEDIS information, goal and accomplishments.

More Information

For more information about our QM program, please contact our Quality Management department at 215-991-4102.