Quality Improvement Program

The Community Health Plan Quality Program is a program that supports quality and performance improvement activities within Community Health Plan and its provider network. The program is driven by a responsibility to the communities and members CHP serves and is aligned with CHP's mission, vision, values and organizational goals.

The Quality Improvement program is built on the organization's definition of quality. CHP has adopted the Institute of Medicine (IOM) quality aims as the definition of quality:

Care that is: Safe, Effective, Patient-Centered, Timely, Efficient and Equitable.

Specific program goals are as follows:

Continuously improve the quality of care and service delivered to Community Health Plan members and other customers, e.g., providers.
To develop, implement, prioritize, and coordinate all activities that are designed to improve Community Health Plan processes and achieve performance excellence.
To ensure a system of quality integration communication that is timely and reports through appropriate channels, to appropriate individuals.
To facilitate documentation, reporting, and follow-up of quality integration activities in order to prevent duplication and facilitate performance excellence.
To complete evaluation activities that may include but not be limited to:
1. Strategic alignment
2. Health plan stability; financial and operational performance
3. Organizational development
4. Member satisfaction; Provider accessibility and availability
5. Chronic disease management
6. Clinical quality, including preventive care and quality of care issues
7. Pharmacy management
8. Credentialing
9. Delegated oversight monitoring
10. Provider satisfaction
11. Sales and marketing