Quality Improvement

The Community Health Plan Quality Program makes sure our service meets clinical and customer service standards. We set some standards ourselves and we comply with those set by government and national organizations that measure quality.

We set and meet our quality standards by using teamwork guided by our mission, vision, values, and goals. The Quality Program is managed by a committee that gets data and recommendations and directs improvement work.

We have programs in place to assess and improve patient safety, clinical quality, and the quality of behavioral health services. We understand that one of the greatest tools in preventing chronic disease and getting appropriate preventive care is knowledge. Our efforts to help you manage your health include programs to manage diabetes and asthma. We help you assess your risk of diseases such as diabetes, encourage you to get proper treatment and care, and inspire you to take charge of your chronic conditions for a lifetime.

To succeed in these efforts, the Quality Program has developed materials to help you better manage your health and to understand your chronic conditions and any complications. Our programs also keep track of how we deliver care to you and provide education for health care staff.

We use HEDIS (Healthcare Effectiveness Data and Information Set) as one set of standards to measure our performance. In 2009, HEDIS results showed that:

  • Immunization rate for 2-year-olds increased by 10% to 14%, depending on the type of immunizations.
  • Well Child exam rate improved by 5.86%.
  • Diabetes care improved. Eye exam rates increased by 5.59%, blood glucose (HbA1c) exam rates increased by 4.51%, and blood pressure control improved by 3.77%.

We want you to be very satisfied with the quality of care and service you get from the health plan and our network of doctors. In the last few years we have worked hard to improve our services.

Our results in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, a national survey of health plans, have improved in areas that are important to you. In 2009, CAHPS results showed that:

  • Satisfaction with the health plan increased by 6%, satisfaction with access to appoint-ments increased by 4%, and satisfaction with personal doctor increased by 3%.
  • Members who said they got the help they needed from Customer Service increased by 3%.

Our commitment to you is that we will not stop working to improve until all of our members are very satisfied with our services.

We will continue to work to improve these and other areas in future years. We want you to be able to manage your chronic conditions and learn from the information that we give you. We want to help you work with your doctor to best manage your care and make sure that you get the services that you need. 

If you have any questions about or would like more information about the Quality Program, call the Community Health Plan customer service team at 1-800-440-1561 toll free. If you are hearing or speech impaired, please call TTY 1-866-816-2479 toll free or local 206-613-8875.

How We Make Sure You Get the Best Health Care