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Quality Improvement Program

Quality Improvement Program
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The Quality Improvement Program is designed to:

  • Expand access and enhance the quality of health care
  • Enhance customer satisfaction
  • Maximize the safety and quality of health care delivered to members
  • Improve efficiency and effectiveness
  • Fulfill quality-related reporting requirements of accrediting bodies and other local, state and federal regulatory and external review organizations

The annual Continuous Quality Improvement (CQI) Work Plan describes specific activities that Horizon NJ Health will perform to meet the established goals. The annual Quality Improvement Program Evaluation reports how well Horizon NJ Health has performed. Some of the activities include:

  • Improve HEDIS Scores
  • Improve Member/ Practitioner Satisfaction: CAHPS, or Consumer Assessment of Healthcare Providers and Systems, is a standardized survey that allows members to evaluate their experiences with health care. Three populations were chosen for the survey: Adults, Children General Population and Children with Chronic Conditions. The Satisfaction Survey is a means of receiving feedback from practitioners and office staff regarding Horizon NJ Health operations and areas of improvement.
  • Quality Improvement Projects (QIPs). These projects are initiatives that improve the safety of our members in all settings.
  • Maintain NCQA (National Committee for Quality Assurance) accreditation.

To view the progress we are making toward our goals, please review our Quality Improvement Program Evaluation and visit the Progress Toward HNJH’s Goals page.

For further information about Horizon NJ Health’s Quality Improvement Program goals, processes and outcomes concerning care and service and/or to obtain a copy of QI Program information, please contact Practitioner Services at 1-800-682-9091. To access Horizon NJ Health’s current NCQA ranking, please visit http://healthinsuranceratings.ncqa.org/2017/search/Medicaid.