Quality Improvement Plans a) Upon notification of required improvement as specified in 5.2.3 and Attachment 4 – Quality Transformation Initiative, Contractor must submit a Quality Improvement Plan to Covered California detailing the action(s) it plans to take to improve quality.
b) For each product that has failed to meet the Measurement Year 2018 25th percentile composite benchmark for the QRS Clinical Quality Management Summary Indicator measures for two (2) consecutive years, the Quality Improvement Plan must include annual targets for measure score improvement and describe actions to improve specific measures or describe systemic improvement efforts intended to improve performance on multiple applicable measures.
c) For each QTI core measure for which Contractor scores below 25th percentile national benchmark, the Quality Improvement Plan must include annual targets for measure score improvement and describe the quality improvement activities intended to improve performance on that specific QTI core measure in accordance with Attachment 4 – Quality Transformation Initiative.
d) Contractor’s Quality Improvement Plan must detail the actions that it is undertaking, or will undertake, to improve quality in each of the following:
i. Engaging and supporting providers including physicians and physician groups, in improvement activities, for example development of registries and data analytics, facilitating data exchange, and innovative approaches to patient engagement to improve coordination, integration, and care delivery;
ii. Contracting with higher performing providers;
iii. Developing or building on existing quality incentive programs for contracted providers that include or focus on measures in the QTI core measure set or other QRS Clinical Quality Management Summary Indicator measures;
iv. Using consumer incentive programs to target desired behavior change that could impact the QTI core measure set or other QRS Clinical Quality Management Summary Indicator measures;
v. Improving data quality and completeness; and
vi. Eliminating providers from its networks based on their poor performance. To the extent this strategy is undertaken, Contractor must explicitly identify in the Quality Improvement Plan any providers, including individual physicians and physician groups, identified as poor performing that Contractor is considering for removal from its QHP network if quality performance does not improve. If these providers are designated ECPs or serve predominantly low-income or vulner...
Quality Improvement Plans. The MOHLTC will work with the LHINs to support the development of Quality Improvement Plans by providing the required templates, guidance and accompanying supports.
Quality Improvement Plans. All services will be required to update their Quality Improvement Plans annually and to hold these on site and available for review at any visit to the service.
Quality Improvement Plans. The Recipient shall prepare the Quality Improvement Plan in accordance with Health Quality Ontario guidelines.
