Quality Program

Quality Improvement Steering Committee Description

The Colorado Health Partnerships (CHP) Quality Program always works to improve client care and services.

The CHP Board has given the Quality Improvement Steering Committee (QISC) control of this program. They control this program for the Medicaid contract. The QISC meets at least quarterly.

QISC’s main job focus is on tracking and testing information. They do this to find out how well CHP is providing client care and services. They also measure if we are meeting the conditions of our contract. QISC reviews reports that show client satisfaction and complaints. These reports also track access to services, hospital readmissions, quality of care, cultural competency and more. If QISC finds a problem area, they work to identify the cause of the problem. Then, they develop a plan to correct the problem. Then, CHP puts the plan into place. QISC then reviews reports to be sure the problem is getting fixed.

Quality Improvement Steering Committee Goals

The QISC has set the following goals:  

  1. Have consumers and family members become more involved with QISC efforts.
  2. Make sure that providers are meeting clinical practice standards. Ensure they are doing what is required in the contract.
  3. Analyze and evaluate all of the outcomes data.
  4. Work with quality, clinical and member affairs teams to identify evaluate and take action on chances for clinical practice improvement.
  5. Measure QISC value and efficiency.
  6. Assess records of emergency evaluations for children/adolescents.
  7. Make sure there is compliance with EQRO standards.

To learn more about our quality program, call CHP at 1-800-804-5040.

Performance Improvement Advisory Committee

Performance Highlight

Improving performance is a core belief of the Colorado Health Partnerships’ Quality Improvement Steering Committee and Clinical Advisory/Utilization Management Committee (QISC/CAUMC).  The QISC/CAUMC employs a variety of techniques to evaluate and improve performance and outcomes to identify potential performance/quality improvement initiatives. When available, the Committee compares performance to national benchmarks, performance of other BHOs or like organizations, and to previous year’s performance. Statistical testing may be applied, when appropriate, to determine whether an increase or decrease in performance is truly (significantly) valid, or whether the difference is due to a random variation. Trending over time is also useful in showing where performance may be improving (or declining) even if testing doesn’t show a significant difference from one time period to the next. When differences are detected, further analysis will occur. This may include analysis of more detailed or updated data, input from members or providers closely involved in the specific activity being evaluated to better understand what is occurring, or evaluation of circumstances or barriers that may be impacting performance. Once this process is completed, changes or interventions are often developed and implemented, and re-measurement occurs to determine whether the changes made have had a positive impact upon performance. The re-measurement is typically evaluated to determine whether the changes were effective, or whether more time, revision or additional change is necessary for improvement.

One of CHP’s efforts is to bring the information contained in this website to providers in an easy to access and understand manner.  The examples provided examine a variety of areas seen in the trending report. All information is associated with fiscal year 2016 and will be updated annually or when warranted.