Quality Improvement Program and Compliance and HEDIS
Provider Type
- Physicians and Practitioners
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Health Net tracks and monitors quality of care and service in a number of ways, including through the Healthcare Effectiveness Data and Information Set (HEDIS®). The National Committee for Quality Assurance (NCQA), a not-for-profit organization, created and maintains HEDIS to assess, report on and improve the quality of care and service provided by organized health care delivery systems. HEDIS is the most widely used set of performance measures in the managed care industry. Participation in this effort allows health care purchasers and providers to compare Health Net's performance relative to other health plans and to identify opportunities for improvement.
In addition, Health Net participates in multiple quality improvement organizations, including:
- California Quality Collaborative (CQC): a healthcare collaborative that seeks to improve clinical care and service for all Californians by providing strategies at the point of care. CQC programs are available to providers to improve chronic disease care, patient satisfaction, and care efficiency. For a listing of educational programs and patient satisfaction and condition management resources visit www.calquality.org.
- The Leapfrog Group: a nonprofit organization dedicated to promoting transparency, safety, and quality in healthcare. Health Net purchases The Leapfrog Group data, and promotes their ratings and standards to network hospitals, members, and the community.
- Cal Hospital Compare: a nonprofit organization providing public performance ratings for a multitude of California hospitals. Health Net contracts with Cal Hospital Compare to obtain Poor Performer and Honor Roll reports and data files to help inform hospital quality initiatives.