Making sure you get quality care

We want to make sure you receive safe and effective health care services and have a positive experience as a Priority Health Medicare member. That's why our Quality Improvement Program sets standards for the quality of the health care you receive and goals for meeting your expectations. We monitor and evaluate how your health care is delivered and how well we provide services to you. We use what we learn to improve the care and services you receive and help you to live your best life.

Our standards require that the care you get is:

  • Accessible
  • Safe
  • Patient-centered
  • Reliable
  • Timely
  • Efficient
  • Cost effective
  • Proven to promote and improve health

We monitor health care quality in several areas, including:

  • Patient safety
  • How effective your health care is at making and keeping you healthy
  • How well your doctors coordinate your care among themselves and with us
  • How well your doctors, manage your medications
  • Your access to and the availability of doctors and other health care services
  • Your satisfaction, including the resolution of grievances and appeals
  • Our compliance with state, national and federal guidelines and requirements
  • How well we help you manage chronic diseases, including services and education provided to you and your doctors
  • The speed and helpfulness of our customer service, including claims processing and telephone contact

Our committees help us meet our standards and improve your health care

Priority Health’s Board of Directors, our providers, leadership, and front-line staff all participate in quality improvement activities. We have several quality teams that work hard for you to receive the best care and service possible. Our Quality Integration Committee (QIC) is a board level committee responsible for the strategic direction of Priority Health’s clinical services and improvement activities. From the board level on down our QI teams oversee the performance of clinical services and ensure quality goals are met as cost effectively as possible to provide you with exceptional, safe, and affordable care.

We're committed to continuous improvement

A full evaluation of the QI workplan occurs quarterly to see how we are doing on achieving quality goals.