7 Ideas to Help Optimize Your Quality Improvement Program

October 19, 2016

Are you looking to improve quality in an efficient and cost-effective manner?

Follow the below tips to get the most from your health plan quality improvement programs:

  • Keep Members Engaged

Keeping members engaged is your key to success. You will earn your members' trust through your efforts to educate, prevent disease, and detect conditions early on. At the same time, you remind your members of those efforts, they become more attuned to what their health plan does for them.

  • Let Members Know of Gaps in Their Health Care

Remind members about health screenings, vaccines, and regular check-ups. Reach out to them by the best method possible for each patient: email, text messages, or phone calls. After your members complete their health screenings, follow-up with them to remind them to contact their primary care physicians. Their personal physician will give them the screening results and tell them if they require any further health care related to the screening.

  • Identify High-Risk Members

High Risk Members are members who skip regular visits to their physician or those who do not fill out health risk assessments (especially important for pre-diabetes patients). MedXM will send a staff physician or a staff nurse practitioner to your member's home to help your member complete the health risk assessment.

  • Post-Discharge Follow-Ups

It is imperative for hospital discharge members to follow post-discharge instructions carefully to avoid readmission. They must also contact their primary care physicians for further health care advice on the issue that required hospitalization. Many members do not follow those instructions and many do not contact their primary care physician. For that reason, this particular item is three times as important as others on this list. Scheduling a post-discharge assessment for your members can identify issues and determine recommendations that may just keep your member from needing a hospital readmission.

  • Osteoporosis Screening

Experts say that one-third of osteoporosis cases goes unchecked until a fracture occurs. That makes it critically important to offer an osteoporosis screening that will help to identify those health plan members over age 65 and at-risk for falls. Bone Mass Density Screenings make sense for members who recently fell or who experienced fractures in order to evaluate whether they are at risk for more fractures down the road.

  • Medication Therapy Management and Comprehensive Medicine Review

Chronically ill members often face medicine related problems that range from incorrect dosing, to forgetting to take medicines, to just not understanding how they should administer their meds. They may also need information on the foods they can combine with their particular medicines. Medication Therapy Management and a Comprehensive Medicine Review provide extra help to chronically ill patients to avoid problems from improper med management. Counseling will help your members get the most benefit from their prescription meds.

  • Bring Back the Era of Nurses/Physicians/Physician Assistants' Home Visits

Offer your members the added peace of mind that comes with knowing that they do not have to travel to their doctor's office every time they need follow-up care or a physical assessment. Coordination between your health plan, the member's physician, or a third party provider network completes the circle of care for your members. Everyone concerned with a member’s health care can learn more about the member's physical condition and what additional care they may need. Home visits are generally less than an hour, but that's longer than most doctors give patients during regular checkups. Your members will love the one-on-one attention and appreciate that your plan considers their schedules when planning home visits.

To talk more about this, or member engagement, please contact us. MedXM can help your health plan improve quality outcomes while making your members happier with your services.

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3 Ways Health Risk Assessments Lead to Better Care Management
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