Quality & Member Rights
Check here for Information about quality, patient safety, and Capital Health Plan's quality improvement program.
Capital Health Plan's Vision for Quality
CHP will maintain a reputation as a local, state, and national leader in quality of care and service through
- Excellent accreditation ratings
- Industry-leading member satisfaction
- Very low voluntary disenrollment
- Industry-leading benchmark performance on clinical outcome measures
Capital Health Plan's Quality Improvement Program
The purpose of Capital Health Plan's quality improvement program is to provide health care services that are
SAFE: ensuring that health care services provided for members do not cause harm.
EFFECTIVE: providing services based on scientific knowledge to all who could benefit and refraining from providing services not likely to be of benefit.
PATIENT-CENTERED: providing care that is respectful of and responsive to individual patient preferences, needs and values; ensuring that patient values guide all clinical decisions.
TIMELY: reducing delays for both those who receive and those who provide care; providing care at a time when the care is likely to be most effective.
EFFICIENT: providing care that is free of waste, including waste of equipment, supplies, and time.
EQUITABLE: providing a consistent level of care for all members.
Improving Services for Members
CHP's quality improvement (QI) activities focus on improving the health status and satisfaction of our members. In 2015, CHP made considerable progress toward achieving the short and long-term goals for clinical and service quality and patient safety that were outlined in our work plan. CHP has continued a quality initiative to decrease avoidable hospital readmissions. Capital Health Plan is the highest ranked Commercial and Medicare health plan in Florida, and has a rating of 5 on a scale of 1-5 from the National Committee for Quality Assurance (NCQA) for the Health Insurance Plan Ratings. The Center for Medicare and Medicaid Services (CMS) has also awarded CHP’s Medicare plan with a 5 Star Rating.
Click on the links below to review a copy of our current QI Program Description and Workplan, and an evaluation of the status of our QI activities. If you would like additional information, or need a copy of these documents mailed to you, contact our Member Services department at (850) 383-3311.
Links to Quality and Patient Safety Information
- FDA: MedWatch On-line Voluntary Reporting for Adverse Events
- NCQA 2015 Health Insurance Plan Ratings
- Quality Performance Report Cards for Hospitals: Health Grades
- Patient Safety General Information: Institute for Healthcare Improvement
- Patient Safety Topics and Activities: Joint Commission
- Sentinel Event Alerts: Joint Commission
- Medical Errors & Patient Safety: Agency for Healthcare Research & Quality
End of life decisions about medical care can be much easier when advance directives are used. An advanced directive simply means a statement, made while you are competent, about the medical treatment you want when you consciously cannot make decisions. Decisions made early and communicated plainly may have tremendous value for the person and the family.
Capital Health Plan (CHP) is committed to provide and/or arrange for the provision of quality health care in a cost-effective manner. Consistent with our commitment, CHP has adopted a statement of Member's Rights and Responsibilities.