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2014 CFHP QI Program Results

January 12, 2015

2014 CFHP Quality Improvement Program Results

Each year, CFHP evaluates its Quality Management and Improvement Program (QMIP). The purpose of the annual evaluation of the QMIP is to review and analyze the previous year’s results and actions to see where we improved and where we need to do more work. This annual evaluation helps CFHP move towards our goal of delivering the highest quality care and service to our members and providers.

Some of the highlights of our 2014 QI efforts include:

  • CFHP obtained NCQA Interim Accreditation status in May 2014. Interim Accreditation status reflects CFHP’s commitment to enhance its processes to a national standard of excellence.
  • CFHP decreased unnecessary emergency room (ER) use by nearly 7,000 visits. This was a result of member education and case management efforts that improved member safety by encouraging obtaining necessary services in a more appropriate setting, such as PCP offices or urgent care centers.

  • CFHP understands the importance of moving its opportunities to strengths. Key goals for 2015 are:

  • Continue to prepare for our next NCQA accreditation survey, scheduled for August 2015.
  • Improve member health and provider services through population management strategies that emphasize quality and safety.
  • Improve Member and Provider Satisfaction.
  • More details about our performance on measures of clinical care and member satisfaction are available in the 2014 HEDIS and CAHPS summary. If you would like a paper copy of this document, please call (210) 227-2347 or toll-free 1-800-434-2347.