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Quality Improvement Program | Ambetter from Buckeye Health Plan
Quality Improvement (QI) Program
Buckeye Health Plan’s mission is to improve the health of all members. The Quality Improvement (QI) Program is an important part of this mission. The Program seeks to improve the quality of care, safety, and appropriate use services for all Buckeye Health Plan members. The QI Program monitors the quality of care and services provided in the areas below:
- Making sure members get the care they need, when and where they need it
- Making sure that members are receiving quality care
- Cultural needs of our members
- Member satisfaction
- Member/Patient Safety and Privacy
- Offering a wide variety of provider specialties
- Health plan services members are using
As with Buckeye Health Plan’s mission, the goal of the QI Program is to improve the health of all members. This is achieved through many different activities. Some of our QI goals include the following:
- Good health and quality of life for all members
- Care provided by Plan Providers meets industry-accepted standards of care
- Plan customer service meets industry-accepted standards of performance
- Provide members with Preventive Care reminders annually
- Incomplete or duplicate services will be kept to a minimum through QI activities across Plan departments
- Compliance with all State and Federal laws and regulations
- Evaluate Enrollee experience through the use of a satisfaction survey called QHP (Qualified Health Plan). This survey tells us how satisfied you are with your health care, your provider(s), and with Buckeye Health Plan. Please see the document below for Buckeye Health Plan’s QHP performance.
- Evaluate the quality of health care through HEDIS® (Healthcare Effectiveness Data and Information Set). These scores tell us when you have received the type of care you need. Please see the document before for Buckeye Health Plan’s HEDIS® performance.
If you would like to learn more about Buckeye Health Plan’s QI activities, or would like a printed copy of this information free of charge, please contact Member Services.
QHP: CMS rates qualified health plans (QHPs) offered through the Exchanges using the Quality Rating System, which is based on third-party validated clinical measure data and QHP Enrollee Survey response data. CMS calculates QRS ratings annually using a 5-star scale. QHP issuers contract with HHS-approved survey vendors that independently conduct the QHP Enrollee Survey each year. QRS ratings and QHP Enrollee Survey results may change from one year to the next. For more information, please see CMS Health Insurance MarketplaceSM Quality Initiatives website at:
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).