Corporate Quality Improvement Program

This section of the Priority Health Provider Manual describes the coordination, integration and oversight of the corporate quality improvement program for health care and services provided to members of all plans.

Get a complete copy of Priority Health's Quality Improvement Program by contacting your physician account executive.

Goals and objectives

1. To establish formal activities that review and safeguard the quality of medical care and services provided to Priority Health members and to implement corrective actions that address deficiencies identified in the quality of care and/or services.
2. To continuously monitor, analyze, and improve the level of performance of Priority Health's network performance and programmatic outcomes by examining the systems and processes by which care and services are provided.
3. To increase the likelihood of desired health outcomes that are consistent with current professional evidence.
4. To continuously improve information that supports Priority Health's members, providers, practitioners, and employers in making informed decisions about health care services.

Program components

• Scope of the program
• Management of substandard quality issues
• Coordination of activities
• Reports
• Confidentiality
• Program evaluation
• Yearly quality improvement plan
• Delegated functions