Improving Quality
Quality Improvement Programs
Improving Outcomes, Timely Access to Care, and Systems of Care
HPSM’s Quality Programs aim to improve timely access to preventive care, provider systems of care, and health outcomes among our members. Our criteria include HEDIS clinical and access measures.
| Current Programs |
Measure
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HEDIS
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Incentive Program
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Summary of
Program Components
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Health Education Behavioral Assessment
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- Risk factor assessment tool
- Intervention documentation tool
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Teen Well Care Visit
12 to 21 years
|
Annual Visit
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- member
- provider reimbursement
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- provider and member education
- provider toolkit with billing tip sheet
- provider feedback
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Childhood Immunization
|
Required Shots by Age 2
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- access to SMC immunization registry
- free registry software and training
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| Timely Prenatal and Postpartum Care |
Timely Check-ups |
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| Cervical and Breast Cancer Screening |
Pap and Mammogram
Screening rates
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- Provider reports
- Member mailings
- Member reminder protocol
- Partnerships with CBOs
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Diabetes Management
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HbA1c, LDL,
Eye exam, Nephropathy
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- Disease management program for high-risk members
- Self-tracking tool for members
- Provider report card
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Asthma Management
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Prescription of
long term control medication
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- Asthma action plan
- Member support groups
- Provider training
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Chlamydia Screening
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Annual Screening rates
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