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The role of quality standards for contracted providers is to acknowledge the conditions of participation for member care and services including the evaluation of key performance indicators. CHP recognizes that every provider agency engages in routine review and improvement activities in order to deliver the best possible member care and this document helps to clarify key areas that CHP evaluates results of provider agency performance.
The process of incorporating all content standards and effective processes for every member care setting can be broad; nonetheless, these quality standards focus on certain key factors as contributing to success for member outcomes. These factors and related factors help CHP move beyond ‘hunches' in evaluating quality of provider performance and assist CHP in focusing efforts on specific quality indicators. In the big picture of these quality standards, they help represent an important step in using data for improving quality outcomes for members.
This is the overall goal – to incorporate key indicators as part of an ongoing quality performance improvement program for CHP and for the provider. Changes to the indicators will be implemented and monitored over time.
The reality of these standards is that it gives the provider and CHP a place to start evaluating common activities that may reveal the presence of more effective practices. The provider and CHP will want to take steps to improve care in those areas where inadequate or problematic care provision is noted.
Provider Quality Standards By Service Area*
Each document includes performance indicators and corresponding dashboard information.
*As of 3/22/11, not all service areas have fully developed quality standards or performance indicators. Please check back to this website for new service areas and revisions to existing versions. The most current versions will have a date on the front cover that will identify the most recent version.
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