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Quality Assurance and Performance Improvement
The Denver Health Medical Plan (DHMP) Quality Improvement Program is designed to support the mission of DHMP by promoting the delivery of high quality, cost effective and accessible health care services that enhance or improve the health and well being of our members.
The Quality Improvement Program:
- Oversees the Quality Assurance Performance Improvement Plan for DHMP, including regulatory requirements, committee structures, ongoing continuous performance improvement initiatives and NCQA health plan measures. This all in an effort to reduce health care disparities and improve equity in Denver and other Colorado communities that we serve.
- Monitors performance improvement activities for all DHMP health plans to include continuity and coordination of care between medical and behavioral health care. We serve as a framework of the continuous QI cycle, identifying and acting on opportunities related to coordination of care and/or social determinates of health. This involves ongoing collaboration with contracted network providers and all areas of DHMP, to promote synergy, reduce health care disparities and improve organizational diversity, equity, Inclusion and belonging.
Clinical and Preventive Practice Guidelines
Preventive Guidelines
- Care of Well Newborn
- Clinical Preventive Health Recommendations for Adults
- Fall Prevention for Adults 65+
- Medicaid Behavioral Health Practice Guidelines
- Pediatric, Adolescent and Adult Immunizations
- Prenatal, Perinatal and Postpartum Care Guidelines
- Routine Cervical Cancer Screening
- Smoking Cessation
- Well Child and Adolescent Health
Quality Assurance Performance Improvement
Program Descriptions
- Describe the QI Program and associated activities
Quality activities are data driven and responses are considered with a health equity lens - Outline various committee structures
Evaluations
- Analyze QI activities from the previous year.
Quality activities are data driven and interventions are designed in response to the data. - Detail how we performed in different measures (cancer screenings, member satisfaction, care management)
Work Plans
- Outline the work and goals of various departments across the organization for the coming year (forward looking 2024-2025).
- The work plan is developed for the upcoming year using prior year quality activity data.
Denver Health Medical Plan, Inc. has earned Accreditation from the National Committee for Quality Assurance (NCQA). The accredited rating is awarded to organizations with programs for service and clinical quality that meet basic requirements for consumer protection and quality improvement. NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.