AvMed's Quality Improvement Program Summary

The mission of AvMed Health Plans is to improve the health of our members. We provide members with quality, cost-effective plans and excellent member services. Our vision is to be the health plan of choice. As one of the state's oldest and largest not-for-profit health plan, AvMed's corporate culture is defined by compassionate, collaborative and ethical behavior focused on delivering superior member service.

The National Committee for Quality Assurance developed HEDIS® (Healthcare Effectiveness Data and Information Set) as a tool for health plans to collect, analyze and report identical performance measurements on important dimensions of care and service. HEDIS allows you to see how well we do from one year to the next in encouraging members to get all the proper screenings and encouraging our contracted physicians to deliver care according to the standards of their professional associations.

To view our HEDIS Report Cards click here The last three years of AvMed's HEDIS reports can be selected from the bottom of the page.

By viewing AvMed's HEDIS publications, you can:

• Compare rating from one year to the next
• See specific information on our rates for measures such as:
• Breast, cervical and colorectal cancer screenings
• Diabetes Care
• Cholesterol screenings
• Childhood immunizations
• Prenatal and postpartum care
• Member Satisfaction with our contracted, independent doctors and their office personnel

The policies, procedures and activities of the AvMed Health Plans departments and Quality Improvement Committees are integrated into a Quality Improvement Program that is implemented throughout AvMed's service area. AvMed's Board of Directors oversees the Quality Improvement Program to ensure that the performances of Quality Improvement functions are timely, consistent, and effective.

The Quality Improvement Program is systematic and ongoing. It encompasses accessibility, availability, continuity, appropriateness, timeliness, patient safety, quality of care and services provided to AvMed members to meet the cultural and linguistic needs of our diverse population. The Quality Improvement Program pertains to all AvMed members, participating providers and practitioners.

The scope of the Program includes integration with most of the departments and processes within AvMed.

Quality Improvement activities during each year include, but are not limited to, improving preventive care, clinical care, medical management, physician services and member services. These activities focus on improving:

• Breast and Cervical Cancer Screening
• Prenatal and Postpartum Care
• Childhood and Adolescent Immunizations
• Comprehensive Diabetes Care
• Depression
• Asthma
• Treatment after a Heart Attack
• Cholesterol Management
• Controlling High Blood Pressure
• Accessibility and Availability of network services
• Member and physician satisfaction surveys

If you would like to participate more directly in our Quality Improvement Program, have any comments on how we can improve, or would like a copy of our HEDIS Report Cards, which includes most of our QI Program activities, and/or a copy of AvMed's Quality Improvement Program Description, and/or a copy of AvMed's Quality Improvement Program Summary, email us at providers@avmed.org or call AvMed's Provider Service Center at (800) 452-8633.