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Quality

The Quality Improvement Program includes initiatives to ensure that members are receiving age-appropriate preventive health screenings and interventions to optimize health.

The information on this page provides useful information and tools for managing patient care based on industry-standard clinical practice guidelines.

    Preventive Depression Screening Program

    This program promotes collaboration, continuity and coordination between medical and behavioral health care.

    New: HEDIS Measurement Year 2024 Toolkit

    HEDIS® Measurement Year Adult Pocket Guide 2024

    HEDIS® Measurement Year Adult Pocket Guide 2024

    HEDIS Measurement Year 2023 Toolkit

    HEDIS® Measurement Year Adult Pocket Guide 2023

    HEDIS® Measurement Year Adult Pocket Guide 2023

    HEDIS® At-a-Glance STARS Measures

    Quality Measures

    Controlling Blood Pressure Flyer

    (COL-E) Flyer

    Blood Sugar Controlled – Glycemic Status Assessment for Patients With Diabetes (GSD)

    Use this tip sheet for best practices on how to talk to your patients about why they need to maintain adherence and how to track their medications.

    OMW – Osteoporosis Management Flyer

    Social determinants influence health in very direct ways. A patient’s housing, food, and safety needs can create barriers blocking quality care and can contribute to poor health.

    Examples of Centers for Medicare and Medicaid Services Star measures which use statin therapy to evaluate health plans.

    Transitions of Care (TRC)

    Medicare Incentive Programs

    Unlock the Benefits of Partnership!

    Primary care providers have the opportunity to earn a bonus by addressing preventive care and closing care gaps.

    Dagiti Makatulong a Dokumento


    Important Information on CPT II and HCPCS Codes

    CAHPS and HOS Resources

    CAHPS (Consumer Assessment of Healthcare Providers and Systems) Resource Guide

    Consumer Assessment of Healthcare Providers and Systems (CAHPS) is a survey tool that asks patients to evaluate their experience with their health plan and at providers’ offices.

    HOS Health Outcomes Survey

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    Last Updated On: 5/14/2024