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Quality Assessment and Improvement Program

HPSM’s Quality Assessment and Improvement Program (QAIP) is designed to systematically manage the provision and continuous improvement of the quality of care and service provided to HPSM members. Measures of quality of care include:

  • Provider Access
  • Appropriateness of Care
  • Disease Prevention
  • Health Outcome
  • Member and Provider Satisfaction
  • Health Education
2009-2010 Quality Assessment and Improvement Program Description

Annual Evaluation of Program Efforts

  • Physician Credentialing (PCP and Specialists)
  • Appointment Waiting Times in Specialty Care
  • 2009 HEDIS (for 2008 Services)
  • Quality Improvement Projects
  • Member Satisfaction

HEDIS Presentation
HEDIS now represents Healthcare Effectiveness Data Information Set

Quality Improvement Projects and Initiatives

HPSM’s quality improvement projects focus on advancing specific best practices and evidence-based guidelines. These efforts are aimed at increasing HPSM’s performance on required measurements and enhancing systems that promote prevention.

  • Adolescent Health Visits
  • Mammogram and Pap Test
  • Prenatal and Postpartum Care
  • Medi-Cal Pay-for-Performance
  • Diabetes Management
  • Asthma Management
  • Immunization Registry
  • Medi-Cal P4P
    Program that aligns provider incentives with preventive measures.
  • HEDIS Quality Projects
    Projects that support HEDIS and other state requirements.
  • QI Advisory Committees
    Entities that provide QI oversight.
  • CMS and DHHS initiatives
    Links to information on home health, nursing home, and ESRD projects, in addition to provider tools.

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