Regulatory
This Excel Spreadsheet is updated monthly as part of our QI Program and tracks most of our NCQA Activities throughout the year.
What is a Work Plan?
The QI team needs to evaluate current resources and process for a more efficient request of data, review outcomes, and implement. There is an opportunity to build a unique board in this platform.
What is Power BI?
By harnessing this power, the Quality team will be able to strategically improve health outcomes, identify and track results, and analyze the impact of interventions.
What is data?
PIPs are to be turned into the state at this frequency.
What is quarterly?
This is an innovative process that is conducted to identify issues that are impacting provider education.
What is a Barrier Analysis?
Home State Health is in the process of achieved a huge accreditation that will be a huge implementation throughout all areas of the health plan.
What is Health Equity?
Routine review and analysis by team members of measure outcomes are documented in this action plan.
What is Measure 360?
These surveys are used to identify and implement interventions to improve member satisfaction and experiences.
What is CAHPS/QHP/BH ECHO?
This PIP is developed to address the new member journey and identify challenges member’s face.
What is member experience?
The Quality Improvement department is in the process of implementing the next phase of the provider strategy through close partnership with network providers with this department.
What is Provider Relations?
The Health Plan submits for accreditation every 3 years. We are currently in an “off year” for submissions.
What is Ongoing Readiness?
Provider analytics are pulled, and quality outcomes are tracked. This data is organized in a specific manner.
What is “by product”?
Through improved focus on SDoH and member specific needs, we can improve this skill for our members.
What is health literacy?
A key part of a success PIP is having a set of goals for the data will accomplish within the PIP and how useful it will be with implementing strategies.
What is a data plan?
This process was implemented 2/12/2024 across all products lines to an improved review of the practitioners needs.
What is Provider Prioritization?
The QI department holds writing meetings with key stakeholders for the PIPs at this frequency.
What is Monthly?
This assessment for each Medicare H contract, Medicaid (GP, SP, HPRS), and Marketplace will provide the QI team with better knowledge of which members will benefit the most from interventions.
What is a population assessment?
The benefit of using the feedback and learning from this process, allows for better understanding and integration of processes from PIPs into overall strategy.
What is a PDSA Cycle?
In 2024, there are this many PIPs to be written and managed by the health plan that covers 3 different topics.
What is 5?
The increase of this data will allow the health plan to have a better focus on data acquisition.
What is Supplemental Data?
This is an important deliverable that needs to be completed prior to the start of HEDIS Hybrid season.
What is a Hybrid Action Plan?
To create or enhance programs, interventions, and focus studies for PIPs and other QI Projects, this will need to be improved.
What are assessments and impact analysis?
By encouraging this collaboration with other Home State departments like Marketing, Pop Health, Community Engagement; this drives engagement from various perspectives for developing interventions and action items.
What is Cross-Functional Collaboration?
By using this list, it will help the health plan identify those without SDS, educate and collaborate with providers on SDS to increase capture.
What is Prioritized Key Provider List?