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QM Goals for 2022

View quality management resources, including the 2021 member satisfaction surveys by line of business, a summary of 2021 HEDIS rates and examples of 2022 quality management goals. Please note: The following results are pending based on CMS approval.

Quality Management Program Goals

Health Partners Plans (HPP) has a quality management program to make sure that our members receive safe and effective clinical care that is timely, and patient centered. Throughout the year, HPP 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.

A sample of 2021 accomplishments:

  • HPP maintained accreditation status with the National Committee for Quality Assurance (NCQA) and NCQA Multicultural Health Care recognition
  • Continued provider monitoring to address quality of care issues and complaints
  • Timely submission of all regulatory required programs such as HEDIS, EQR, the process improvement plans, Patient Centered Medical Home (PCMH), Community Based Care Management (CBCM) and technical responses to the PA state contracted auditor, IPRO
  • Implemented a workgroup to improve Hemoglobin A1c (HgA1c) results for African American members with an uncontrolled HgA1c

Quality Management goals for 2022 and some specific objectives include:

  • Improve health outcomes through greater access to quality care
  • Improve HEDIS rates
  • Improve member satisfaction with the plan and provider services
  • Continue post-visit member surveys to understand barriers to members’ satisfaction with their provider
  • Maintain National Committee for Quality Assurance (NCQA) accreditation
  • Educate all stakeholders on the 2022 NCQA Standards and Guidelines to maintain accreditation
  • Ensure member complaints and quality of care cases are opened and processed within specified timeframes
  • Address members’ needs from a race, linguistic and ethnicity perspective
  • Ensure contractual reports are received timely from delegated vendors
  • Process all credentialing and re-credentialing files within regulatory timelines
  • Continue reviewing prescription drug claims and monitoring opioid utilization to improve patient safety/cost effectiveness

For more information

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