Unity’s Quality Improvement Program is designed to ensure members have access to high quality health care services. Each year, we establish program priorities and goals. The goals are partially based on how we match various national quality standard benchmarks, our own benchmarks, best practices and practitioner/member satisfaction input.
Our priorities include:
During the past year, our initiatives have centered around assisting members with medication adherence (filling prescriptions and staying on medications), monitoring for appropriate lab tests when taking certain medications and health coaching. These will remain our focus for the coming year as well as researching and implementing programs to address other health issues, including behavioral health.
Measurement of the effectiveness of clinical services is done yearly through chart reviews for Healthcare Effectiveness Data and Information Set (HEDIS®) measures. Unity trends these results, looking for performance differences, and then determines, with feedback from Unity practitioners, plans for interventions as needed. The HEDIS measures are part of an ongoing report card that allows us to compare our service outcomes with other local managed care organizations to help us understand how we are doing within our geographic area.
Our ongoing interventions include asthma, diabetes, hypertension, anxiety, depression and Attention-Deficit/Hyperactivity Disorder health management programs; prevention and wellness reminders; wellness rewards/reimbursements; weight management and behavioral health programs. You can find more information about these initiatives at unityhealth.com by selecting Health &Wellness.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
HEDIS is a set of health care performance measures that covers eight areas of care such as prevention and screening. Some measures use data collected from Unity claims while other measures’ data is collected through claims plus medical chart review. HEDIS may also be supplemented with other data sources such as the Wisconsin Immunization Registry (WIR).
Our annual HEDIS 2011 results, measured in 2010, show 18 measures met the 90th percentile meaning Unity performed better than 90% of other HMOs in the country. The 75th percentile was met in 40 measures.
If you or your employees would like more information about specific HEDIS results for 2011, please email Health Services at
healthservices@unityhealth.com and place HEDIS in the subject line.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
