Quality Improvement Program
We are committed to the provision of a well-designed and well-implemented Quality Improvement Program (QI Program). Our culture, systems and processes are structured around its mission to improve the health of all enrolled members.
The scope of the QI Program is comprehensive and addresses both the quality and safety of clinical care and quality of services provided to Home State’s members. We incorporate all demographic groups, care settings, and services in its QI activities, including preventive care, emergency care, primary care, specialty care, acute care, short-term care, long-term care (depending upon Home State’s products), and ancillary services.
Goals & Objectives
Our primary quality improvement goal is to improve members’ health status through a variety of meaningful quality improvement activities implemented across all care settings and aimed at improving quality of care and services delivered.
We accomplish this goal by:
- Recommending policy decisions
- Collection and reporting Healthcare Effectiveness and Data Information Set (HEDIS) and Consumer Assessment of Health Plans Survey (CAHPS) data (as reported below)
- Analyzing and evaluating the results of QI activities including HEDIS/CAHPS using the NCQA Quality Compass as our goal.
- Ensuring practitioner participation in the QI Program (through planning, design, implementation and review)
- Instituting needed actions for improvement
- Ensuring follow-up, as appropriate
For consideration to participate in the Home State network, all licensed physicians and other licensed healthcare professionals who have an independent relationship with Home State must complete an application for participation and submit copies of applicable supporting documentation.
Cultural Competency Plan
Home State is committed to establishing multicultural principles and practices throughout its organizational systems of services and programs. That mission is supported by facilitating the process by which Home State can respond to the healthcare needs of all individuals, regardless of their ethnic, cultural, religious beliefs or language.