Quality Management and Improvement Plan Requirements Sample Clauses

Quality Management and Improvement Plan Requirements. The MCO’s Quality Management and Improvement Committee, in collaboration with the MCO’s Medical Director, must develop an annual Quality Management and Improvement Plan. The plan must identify the MCO’s quality management goals and objectives and include a timeline of activities and assessments of progress towards meeting the goals. The MCO must submit its Quality Management and Improvement Plan to OMPP annually and must be prepared to periodically report on its quality management activities to the Hoosier Healthwise Quality Improvement Committee. The MCO’s Quality Management and Improvement Plan must: • Establish program goals and objectives specific to the Hoosier Healthwise population to improve the MCO’s functioning, improve the delivery of health care services and improve health outcomes. • Identify specific tasks, persons responsible, and timelines for completion for each activity. • Demonstrate an effort toward implementing enrollee-targeted or PMP-targeted programs that result from areas for improvement identified through readiness reviews, focused studies and internal quality improvement efforts • Demonstrate that its quality improvement program is integrated throughout the organization, and through any of its subcontractors when appropriate, for the purposes of assessment, evaluation and implementation of modifications and changes The MCO must also develop an annual Quality Management and Improvement Summary Report that documents the previous year’s quality management projects, problems, issues, assessment of its data collection and monitoring processes, performance results to its internal standards or targets, benchmarks or industry standards that have been identified by OMPP, identification of corrective actions and results of corrective actions. The MCO Reporting Manual contains more information regarding the annual Quality Management and Improvement Summary Report.