Medicare - Quality Improvement |
Program Overview
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ConnectiCare does not advertise, market, or promote any specific products or services to members or practitioners when discussing a member’s health condition.
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ConnectiCare’s Quality Improvement Program (QIP) was developed to improve the physical and mental well-being of its members, and to promote the delivery of high quality care and service. We embrace the continuous improvement model to ensure that the care and services provided to our members meet or exceed established local, state, and national managed care standards.
The Quality Assurance Committee (QAC), comprised of members of the Board of Directors and network physicians, is the governing body of the QIP. The overall responsibility for the development and functioning of the QIP resides with ConnectiCare’s chief medical officer and the Quality Management Committee (QMC). The QMC under the direction of the senior medical director and the responsibility for planning, designing, imple- menting and coordinating QI activities.
Participating physicians may be involved in some or all of the following QI activities:
• Activities that promote continuity and coordination of care between medical specialties or medical and behavioral health specialties.
• Surveys on various QI activities such as how you care for patients with depression or your satisfaction with ConnectiCare.
• Receipt of a list of members who have care opportunities.
• Receipt of a list of members on certain medications with recommendations for follow up.
• ConnectiCare’s physician advisory committee.
• Recredentialing activities, which may include a site visit and/or a review of medical records of your ConnectiCare patients.
• Medical record review for HEDIS® reporting requirements.
• Receipt of educational materials or guidelines on ConnectiCare’s clinical quality, health management or preventive health programs.
• A ConnectiCare-sponsored education seminar or symposium.
HEDIS ® is a registered trademark of the National Committee for Quality Assurance (NCQA). ConnectiCare participates, along with many other health plans, in the New England HEDIS ® Coalition. Participants in the Coalition make a commitment to measure their health plan’s performance in the delivery of selected services in the broad categories of preventive medicine, prenatal care, acute disease and chronic disease.
ConnectiCare has many programs to help maintain or improve the health of our members, including:
• Breast and Cervical Cancer Screening
• Chlamydia Screening
• Cholesterol Screening
• Colorectal Screening
• Depression Medication Adherence Program
• Depression: Screening & Management
• Follow-up After a Mental Health Hospitalization
• Influenza Immunizations
• Postpartum Depression Screening
For more information on how we are performing against standards, click here or call us at 1-877-224-8230.
View our preventive health guidelines, which ConnectiCare developed based on nationally accepted guidelines and with input from various participating physicians, as part of our Quality Improvement Program. To request a hard copy, call (860)674-7029
