Quality Health Ideas, Inc.

Supercharging value-based care delivery

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QHI ACO’s ACO Quality Assurance Program

We maintain a comprehensive physician-directed and beneficiary-centered Quality Assurance and Improvement Program that with performance standards for: (1) quality of care, (2) patient experiences and (3) cost-effectiveness.

QHI ACO emphasizes adherence to evidence-based clinical guidelines and care delivery processes that focus on both the needs of individual beneficiaries and the population the ACO serves.

Our Medical Director reports all findings to the QHI-ACO board which directs the Quality Assurance and Improvement Program.

QHI ACO utilizes and follows all NCQA standards and guidelines, and all MSSP quality-related recommendations/regulations.

QHI ACO and all preferred vendors maintain appropriate protection of health information, including the removal of member names, when providing benchmark, historical, and comparative data for ongoing quality improvement.

 

QHI ACO Quality Assurance Policy - CLICK HERE

Meeting Quality Measure Requirements Explanation - CLICK HERE

CAHPS Survey for ACOs Quality Assurance Guidelines - CLICK HERE

 QHI ACO Compliance Program

Purpose: To oversee and ensure compliance with all applicable federal and state rules, regulations and laws, as well as CMS rules and regulations for the QHI ACO MSSP ACO, its practices and participating providers.

Policy:  As part of this ACO’s participation in the MSSP, it is required to develop and maintain an effective comprehensive compliance program to detect, correct and prevent incidences of non-compliance with the requirements of the MSSP, and address potential incidences of fraud, waste and abuse relating to the MSSP and federal health care programs.

This ACO Compliance Program, “ACO CP” is specific to ACO operations.  The ACO CP shall remain in compliance with, and be updated periodically to reflect, changes in applicable laws, regulations, and best practices. 

QHI ACO Compliance and Ethics Training - CLICK HERE

QHI ACO Compliance and our Annual Certification Forms - CLICK HERE

 

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Direct: 860-668-0044