黑暗爆料官方 Quality Improvement Program

Quality Improvement Program

黑暗爆料官方 cares about all our Members. Our vision is a healthy life for every Texan. Our mission is to improve the health and well-being of underserved Texans by opening doors to health care and health-related social services.

Quality Improvement Program

The quality of our care and services is very important to 黑暗爆料官方, as is our Members鈥� safety. Our Quality Improvement Program uses things like quality scores, reports, and Member and Provider satisfaction surveys to see how we are doing.

The program鈥檚 overall objectives are to help us monitor and evaluate real-life opinions about our services and processes, and then use the results to make improvements in areas such as:

Healthcare access and delivery
Customer service and satisfaction
Provider service and satisfaction
Care (disease) management and complex case management
Preventive and interventional healthcare services

Consumer Assessment of Healthcare Providers and Systems (CAHPS庐)

The CAHPS庐 survey asks about the health care you and your family are receiving from 黑暗爆料官方 to help us understand:

How satisfied you are with 黑暗爆料官方
How satisfied you are with your primary care physician and specialist
How fast and easy you can get care
How well you and your doctor talk about your care
How satisfied you are with your care and services
How 黑暗爆料官方 can improve

Healthcare Effectiveness Data and Information Set (HEDIS庐)

黑暗爆料官方 uses HEDIS庐 each year as a way to measure the quality of our care and services. These HEDIS庐 measures also show where plans can improve. 黑暗爆料官方鈥檚 strategic goal is to be better than 75 percent of other Medicaid health plans in the nation.

黑暗爆料官方 Programs for Qualified Members

黑暗爆料官方 offers many programs to make our care and services even better. These include:

Case Management: assigns Case Managers to Members who help them learn to manage their health, follow their doctor鈥檚 plans of care, and get the care they need.
Disease Management: provides education and support to Members with certain chronic conditions.
Medication Therapy Management: connects Members to a pharmacist who helps them manage their medicines.
Utilization Management: helps control costs and ensure the medical need for medicines, surgeries, and hospital stays.
Nurse Line: a free telephone service allowing Members to talk to a nurse about health concerns 24 hours a day, seven days a week

H9826_IT_10045_092919_M Last updated聽October 27, 2020.

Why Choose 黑暗爆料官方?

As a local nonprofit health plan, 黑暗爆料官方 gives you plenty of reasons to join our 黑暗爆料官方. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, 黑暗爆料官方 is always working life forward for you and your family.

鈥満诎当瞎俜� is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.鈥�
鈥� Cecily
Member of 黑暗爆料官方