Quality Improvement Program (QIP)
University of Maryland Health Partners (UMHP) is committed to providing the best possible health care to all of its members. UMHP has an active Quality Improvement Program that monitors the quality of care and service provided to its members. The Quality Improvement Program is integrated throughout the health plan and is governed by a committee structure composed of doctors, nurses and other non-clinicians. These committees regularly measure performance and recommend improvements for all health plan functions.
UMHP continuously evaluates its Quality Improvement Program using nationally recognized measures such as The Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers & Systems (CAHPS). These measures help UMHP determine if members are receiving the care they need and are satisfied with that care. These measures allow UMHP to assess the overall health status of its members to ensure all members remain healthy and well.
Using the results of these measures UMHP annually sets goals and objectives for its Quality Improvement Program. At the end of every year, UMHP reviews its Quality Improvement Program to identify both achievements as well as opportunities for improvement from the previous year.
Examples of 2018 Achievements:
Examples of 2019 Goals & Objectives:
- Ensure that health education resources available to our members are specifically target to their needs. It is UMHP’s goal to ensure its members have the information you need to, along with your doctor, make the best decisions about care that is right for you and your families.
- Focus on population health management: UMHP understands the burdens faced by members with chronic conditions such as diabetes, high blood pressure and asthma. UMHP is improving its population health programs to help you manage your chronic conditions. UMHP’s goal is to increase resources available to its members with chronic conditions to help them manage their health.
- UMHP is committed to improving health care outcomes for its members through a population health approach which includes a focus on improving the individual member experience of care (both quality and satisfaction) while also working to improve the overall health of its total member population. This approach focuses on removing the barriers that members face that prevent them from achieving health and wellness while focusing on providing comprehensive care that is right for members at every stage of life.
- Expand access to care: UMHP is constantly evaluating the adequacy of our network in providing care that meets the physical, mental, social and cultural needs of our members. In 2019 UMHP is focusing on removing as many barriers as we can the prevent you from getting the care that you need. UMHP wants to help you make and keep your appointments and ensure that those appointments are effective one you arrive.
Click on the below drop down buttons to find out more about specific sections of our Quality Improvement Program.
State and National Quality Program Recognition
Based on your feedback, in 2020 UMHP is focusing on improving your access to care as well the quality and accuracy of information available to you over the phone and on our website. *- indicates that the result was not reportable by NCQA due to not enough responses (less than 100).
Based on your feedback, in 2020 UMHP is focusing on improving your access to care as well the quality and accuracy of information available to you over the phone and on our website.
*- indicates that the result was not reportable by NCQA due to not enough responses (less than 100).
Health Education Program:
The goal of the Health Education Program is to empower its members with information on how to take control of their health. The information we gather in our Quality Improvement Program helps us to understand the members we serve, and allows UMHP to take action to provide up-to-date, easy-to-use health education services to our members. Examples of Health Education services provided by UMHP include the regular mailings, newsletters, web-site postings, a 24-hour nurse advice line, community events and population health programs including case management.
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. UMHP outreaches to you to let you know which wellness services would be beneficial to you and helps you access those services. Outreach always comes with education on how to stay healthy. UMHP reaches out to members in different ways such as by phone, letter, text messages and personal contact.
Cultural Competency Program:
UMHP strives to build health care systems that consider members’ ethnic backgrounds, age, gender, lifestyles, language, disabilities, reading levels, religion and areas where they live. UMHP believes that members experience better health outcomes and results when care is delivered in their own language and their cultural background is considered. Providing interpreter services free of charge and building a diverse network of participating providers are two examples of how UMHP takes actions to provide culturally competent care. All UMHP staff are experienced and trained in recognizing cultural differences and their impact on health care.
Providing safe medical care and preventing complications is a priority. Our Quality Program includes multiple methods to ensure safe and effective medical care is provided to our members. UMHP only contracts with well-qualified providers that meet high quality standards. Once providers are contracted their performance is monitored to promote safety and reduce complications. This includes reviewing certain high risk medical procedures or medications to confirm they are necessary, tracking health outcomes and investigating quality of care complaints from members.
For more information on UMHP’s Quality Improvement Program please contact Member Services and ask to speak with the Quality Improvement Department about our Quality Improvement Program or email firstname.lastname@example.org.