Quality Improvement Management - CMS Solutions

AchieveQI

CMS Solutions provides in depth guidance to healthcare organizations in the development and administration of their Quality Improvement (QI) Program.

CMS’ Achieve QI supports healthcare organization’s commitment to facilitate ongoing improvement in the delivery of high quality healthcare. Our QI Management objective is to increase the quality of care for patients and members by optimizing the delivery of cost-effective healthcare services. This is achieved by monitoring clinical care, clinical service and organizational service while identifying opportunities for prioritizing, improving and implementing quality improvement activities.

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Quality Management Activities

CMS Solutions primary QI Management activities focus on preventive care and disease management.

These activities include:

    Data analysis and reporting,
        Programs involving care delivery such as:
            Asthma care,
            Diabetes treatment and
            Screening programs (mammography, immunizations, etc.)
    Patient/Member satisfaction surveys, such as the annual Consumer Assessment of Health Plans Survey (CAHPS)
    Accessibility standards and timeliness
    Practitioner credentialing
    Monitoring patient and member complaints
    Utilization monitoring

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Healthcare

Quality

Process

Management

CMS Solutions assists healthcare organizations plan their quality management program strategy. Measures are selected based on specific criteria, goals, and key characteristics of the organization. Performance is measured based on standards of care established by appropriate and recognized overseeing agencies, accrediting organizations, and payors for programs such as QPP, PCMH, and ACO.

Once the organization’s performance has been determined, CM Solutions helps identify goals for improvement. Based on the goals identified, CMS Solutions provides guidance in the development of an action plan. A plan for implementation along with monitoring to ensure the implementation process occurs according to plan, and adjustments are made as necessary.

Performance is remeasured and if necessary, additional guidance is provided to augment the strategic action plan.

Organization’s Overall Goals

Target Organization Microsystems

Population Health

Care Management

Evidenced-based Industry Standards

Daily Practices

Operating Costs

Patient & Staff Satisfaction

Establish

Improvement

Goals
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