Eligibility and Claims
Pharmacy
Provider Directories
Forms
P4P Portal
CareAdvantage
Healthy Families
Healthy Kids
HealthWorx
Medi-Cal
San Mateo ACE
Health Education
Do You Qualify?
Employment
The Healthy Fight
History
Community Partnerships
Contact Us
 

Quality Assessment and Improvement Program

Program Summary

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
2008-2009 Quality Assessment and Improvement Program Description


Annual Evaluation of Program Efforts

Program Evaluation for 2008 QAIP Activities

  • Physician Credentialing (PCP and Specialists)
  • Sppointment Waiting Times in Specialty Care
  • 2008 HEDIS (for 2007 Services)
  • Quality Improvement Projects
  • Member Satisfaction

HEDIS powerpoint 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.



© Health Plan of San Mateo