At Community Health Plan of Washington, we work to make sure our services meet clinical and customer service standards through our Quality Improvement Program.
Our Quality Improvement Program has three goals: Better Health, Better Care, and Lower Costs. Better Health focuses on activities to improve the health of our members in all stages of life. At the same time, Better Care targets enhancing health services our providers deliver to our members. Finally, the goal of Lower Costs is to make sure that care is appropriate and effectively uses valuable resources. We achieve these goals through measuring performance in these areas and intervening to improve results.
To measure performance, we use national, standard tools. This includes Healthcare Effectiveness Data and Information Set (HEDIS), as well as the Consumer Assessment of Health Plans and Systems (CAHPS). HEDIS is a set of measures for health care quality performance, where rates are reported publicly each year. CAHPS is a member survey, where questions are asked on experiences on access, respect, and responsiveness by the plan and provider. We report results from both tools to the National Committee for Quality Assurance (NCQA). Furthermore, to ensure we best serve members we are accredited by NCQA. You may view our NCQA accreditation status below:
In 2014, Community Health Plan of Washington’s HEDIS measures demonstrated improvement in many areas. The current measures that have improved, stayed the same, or declined total 28 for Medicaid and 34 for Medicare. Eleven of 28 (39 percent) Medicaid measures improved in 2014. Eleven of 34 (33 percent) Medicare measures improved.
In 2014, our CAHPS measures demonstrated improvement in many areas. The current measures that have improved, stayed the same or declined total 11 for Medicaid and 8 for Medicare. Five of 11 (45 percent) Medicaid measures improved in 2014. One of 8 (13 percent) Medicare measures improved.
We provide many resources to help our members stay healthy. One of these resources is an online health and wellness library. The library includes more than 8,000 articles on various health topics, educational videos, and decision-making tools that are available in both English and Spanish. Explore our available health and wellness resources below:
If you have questions or want more information about the Quality Improvement Program, please call our Customer Service at 1-800-440-1561 (TTY 1-866-816-2479) toll free or email us at firstname.lastname@example.org.