Checklists & Guides

Quality Improvement Checklist

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SPH offers solutions to help health plans evaluate and meet all your quality improvement (QI) objectives. Review our quick-reference checklist below to assist with your HEDIS ® and Quality Improvement planning initiatives. Q4 2019 Q1 2020 ❑ Close Care Gaps Reach out to members who are not meeting standards of care via mail, phone, or email to close care gaps and improve health outcomes. ❑ Assess Customer Service Satisfaction Assess members' customer service satisfaction to evaluate effectiveness and implement needed improvements. ❑ Boost Retention and Renewal Remind members to confirm re-enrollment and assess reasons for those not planning to re-enroll. ❑ Conduct Preventive Care Outreach Contact members to promote awareness and compliance with preventive care measures and screenings. ❑ Measure and Analyze Data Measure and analyze healthcare data to proactively prioritize and manage risks and improve health outcomes. ❑ Assess Member Satisfaction with Provider Measure members' satisfaction and their general experience with provider services through a survey like CG CAHPS ® . ❑ Welcome New Members Build member satisfaction and loyalty from the start with new member welcome calls. ❑ Conduct Health Risk Assessments Identify members' health status to initiate and expedite effective healthcare management. ❑ Evaluate Disenrollments Survey "disenrollees" to understand their perspective. This can be important for your retention and renewal efforts. ❑ Promote Medication Therapy Management Educate members about the guidelines and benefits of your MTM program to promote awareness and compliance. ❑ Consistently Engage with Members Develop a plan for continuous member engagement and outreach to improve satisfaction, loyalty, and retention. ❑ Assess Your Provider Network Determine provider satisfaction with the health plan, assess availability of care to members, and update provider information. Contact us for a free evaluation and experienced guidance to help meet your 2020 Quality Improvement objectives | 866-460-5681 TM Years 3 + Quality Improvement Planning Checklist ✓ Population Engage ™

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