3 Things to Consider When Improving Quality

November 23, 2015 Amanda Hurley

Preventive Medicine should always be the foundation of a quality improvement program.

With the great number of overwhelming adverse events, unintended consequences, and poor clinical outcomes, its important to offer services to your members to increase engagement, promote prevention, and improve overall quality through data-driven results.

 The three initiatives below are important to consider when implementing a quality improvement plan.

 1) Health Risk Assessments (HRA’s)

No matter what the line of business, Health Risk Assessments are an excellent tool to add insight, improve member outcomes, and close care and HEDIS gaps. These assessments can cover a number of quality care gaps and are designed to empower members through education and avoid disease progression by early detection of disease conditions. A professional and in depth examination to re-confirm diagnoses and document any new conditions can allow you to positively impact multiple quality measures. Follow up appointments and referrals can create appropriate health plan case and disease management programs to improve prevention and quality strategies.

2) ​Diabetic Retinopathy Exams (DRE’s)

Diabetic Retinopathy is a major cause of visual impairment and blindness. The National Eye Institute claims, "Between 40 and 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy, although only about half are aware of it." But this is preventable with effective screening programs. In addition, offering members complete eye examinations in the comfort of their home or at a retail clinic can cover important diabetes quality and STARS measures.

 3) ​Osteoporosis Screenings

In the United States, one out of every three cases i of osteoporosis goes un-diagnosed. Perform non-invasive ultrasounds on women ages 65+ with a recent fracture to assess and treat their risk for fractures in the future. In correlation with osteoporosis screening results, those who are at risk can also receive a falls risk assessment to prevent injuries.  Doing this at home also ensure the most convenience for the often at-risk patient. Offering osteoporosis screenings can move health plans up by one or more STAR level in one year.

 While there are a host of ways to improve quality, these three initiatives can significantly improve your quality ratings. Through member engagement, prevention, and early detection you can give your members a chance to gain satisfaction with your plan to improve quality measures.

Share this blog post to help others keep these initiatives in mind when planning a quality improvement strategy.

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