Quality Improvement Program

Community Care is committed to improving the health status of the population it serves and, by extension, the community, while offering high quality, cost-effective treatment in an environment that provides prompt access to services and continuous quality improvement. This commitment to continuous improvement in care and services is the underpinning for the quality management program. The quality process is a systematic, organization-wide perspective that involves close coordination with providers, members, and other stakeholders. In coordination with these entities, the quality program determines measurement activities, defines methodologies, sets performance goals and measures against these goals, analyzes results quantitatively and qualitatively, and implements interventions to improve performance when goals are not met. The resources offered below are intended to support providers as we strive together to improve care outcomes for the members we serve.

• Quality Care is our Top Goal

  We are committed to improving the health status of all Community Care members and strive for quality care.

• Accessibility of Services

  Accessibility of services includes timely appointments for members and quick access to Community Care by telephone.

• Clinical Practice Guidelines

  Clinical practice guidelines help providers and members make decisions about appropriate care for specific circumstances.

• Complaints and Grievances

  Member complaints and grievances.

• Continuity and Coordination of Care

  We monitor care coordination and strongly encourage providers to coordinate care with members' other practitioners.

• FAQs

  Quality Management FAQs

• Follow-up Rates

  Community Care monitors and implements interventions to improve rates of timely follow-up care after a hospitalization.

• Member Safety

  We are committed to improving member safety and routinely monitor behavioral health treatment practices to ensure member safety.

• Member Satisfaction

  An annual Member Satisfaction Survey lets providers know if members are satisfied with the care and services they are receiving.

• Members' Rights and Responsibilities

  Community Care staff and providers must be informed of members' rights and responsibilities and support them in daily operations.