Quality Improvement Program (QIP)

University of Maryland Health Partners is committed to providing the best possible health care to all of our members.  We have an active Quality Improvement Program that monitors the quality of care and services provided to our members. The information we obtain in our Quality Improvement Program helps us plan actions to improve the quality, safety and satisfaction with the care and services provided by UM Health Partners, its network of providers and its vendors. Our goal is to help promote your wellness, diagnose and treat problems early and decrease healthcare complications.  Some of the key parts of our Quality Improvement Program include:

State and National Quality Program Recognition

NCQA Accreditation: UM Health Partners has been certified by the National Committee for Quality Assurance (NCQA).  This organization sets high quality standards for Health Plans across the nation.about_usDelmarva Foundation Quality Review: UM Health Partners undergoes an annual on-site review by a Quality Review Organization selected by the State of Maryland Department of Health and Mental Hygiene.  In addition to the annual review, Delmarva Foundation provides ongoing monitoring and feedback about the quality of care provided by UM Health Partners.

Satisfaction Survey

UM Health Partners analyzes feedback from members and providers that respond to the annual Member and Provider Satisfaction Surveys. These surveys are organized by the State of Maryland Department of Health and Mental Hygiene every year. We use your feedback to improve our customer service and your satisfaction with your healthcare experience. UM Health Partners may also conduct satisfaction surveys of its own. Below please see our 2015 scores for the CAHPS survey of adult members. Our rating for “Getting Care Quickly” and “Customer Service” fell below the Maryland MCO average. The Quality Improvement Department will analyze this data and develop action plans to improve these services for our members.

Health Education Program

The goal of the Health Education Program is to empower members with information on how to take control of their health. The information we gather in our Quality Improvement Program assists us to understand the members we serve, and allows UM Health Partners is to take action to provide up-to-date, easy-to-understand health education services to its members. Examples of Health Education services provided by UM Health Partners include the member handbook, mailings, newsletters, our web-site, our 24-hour Nurse-line, community events, disease management and case management services.

Member Outreach Program

The goal of the Outreach Program is to help members get the care and services they need at the right time and the right location. This includes services to help you stay healthy or prevent illness as well as services to help manage chronic illnesses. UM Health Partners reaches out to members in different ways such as by phone, letter, text messages and personal contact.

Cultural Competency Program

UM Health Partners strives to build health care systems that consider members’ ethnic backgrounds, age, gender, lifestyles, language, disabilities, reading levels, religion and areas where they live. UM Health Partners believes that members experience better health outcomes and results when care is delivered in their own language and their cultural background is taken into account. Making interpreter services available free of charge and building a diverse network of participating providers are two examples of how UM Health Partners takes actions to provide culturally competent care.

Patient Safety

Providing safe medical care and preventing complications is a priority. Our Quality Program includes several methods to ensure safe and effective medical care is provided to our members. First, UM Health Partners contracts with well-qualified providers that meet high standards. Other measures to promote safety and reduce complications include reviewing certain high risk medical procedures or medications to confirm these are necessary, tracking health outcomes and investigating quality of care complaints from members.

For more information on UM Health Partners’ Quality Improvement Program please contact Member Services and ask to speak with the Quality Improvement Department about our Quality Improvement Program or email quality@umhealthpartners.com.