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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 wellbeing of our members.
The Quality Improvement Program:
- Oversees the Quality Assurance Performance Improvement (QAPI) 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, social determinates of health (SDOH) and member experience. This involves ongoing collaboration with network providers and all areas of DHMP, to promote and improve organizational diversity, equity, inclusion and belonging while reducing health care disparities.
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.
QI Practitioner/Provider Support
DHMP aids network practitioners/providers in achieving shared objectives of improving quality and addressing population health concerns through quality-related data sharing, offering evidence-based tools for shared decision-making (SDM), and providing support for transforming practices among primary care practitioners. This support includes facilitating the transition toward more integrated or advanced practices and adopting value-based care delivery methods. If your practice is interested in transforming to a Patient-Centered Medical Home (PCMH), be sure to check out our Patient Centered Medical Home Transformation Best Practices tip sheet.
Additionally, DHMP offers cultural competency training for non-Denver Health practitioners and staff. All Denver Health practitioners and staff, including DHMP, take cultural competency training as part of required annual employee training.
The National Committee for Quality Assurance (NCQA) is non-profit organization widely considered to be the gold standard for health plan accreditation, and DHMP is committed to continuously improving the quality, accessibility, and overall member experience of the communities we serve.