Quality Improvement

Quality Improvement

“Your doctor can freely communicate with you about your care and treatment options regardless of any benefit coverage limitations.”

Care1st  wants to make sure you get good care and services.

To help make this happen, we have created a complete Quality Improvement Program.
The goal of the program is to make sure that our promise of giving good care to our members in being met. The program measures many different parts of the care and services we offer. We have provided you some of our results on the links provided.

You can request the results by calling our Quality Improvement Hotline at 877-472-4332.

These measures include:

  • Studies to ensure that appointments are available
  • Studies to ensure that after-hours services are available
  • Studies to measure how long patients wait in the office for an appointment
  • Facility site reviews. This includes looking at access for disabled people
  • Making sure that the network of doctors in your area fits your needs
  • Patient satisfaction surveys
  • Doctor satisfaction surveys
  • Quality of care studies to assure appropriate:
    • Well child visits
    • Immunizations
    • Cervical cancer screening
    • Breast cancer screening
    • Diabetes Care1st Health Plan
    • Asthma Care
    • High blood pressure
    • Prenatal and postpartum care
    • Cholesterol management

Services:


Access to Care Standards

Care1st uses guidelines to ensure that its members have access to care:


Initial Health Assessment (IHA)


QI Annual Evaluations/ Program Goals

Care1st Health Plan administers a robust ongoing Quality Improvement Program with a goal to ensure that members receive the highest quality of care and services.


2016 Quality Improvement Program Descriptions

Providing an effective, system-wide, measurable plan for monitoring, evaluating and improving the quality of care and services:


Care1st has also developed programs to help members with their medical conditions, which include:

  • Asthma Program (Medi-Cal)
  • Congestive Heart Failure Program (Medi-Cal and Medicare)
  • Coronary Heart Disease Program (Medi-Cal)
  • Chronic Obstructive Pulmonary Disease (Medicare)
  • Healthy Start Comprehensive Prenatal and Postpartum Program (Medi-Cal)