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 to those not likely to 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 2015 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.
QI Program Description (pdf 170.76 kB)
QI Program Evaluation (pdf 137.23 kB)
QI Behavioral Health Program Description (pdf 200.39 kB)
Accreditation and Quality Report Cards
The National Committee for Quality Assurance (NCQA) is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of health plans. CHP has maintained an Excellent Accreditation Rating, the highest accreditation rating possible from NCQA for fifteen years. Click on the NCQA web-site above to request a report card for CHP. The report card will display how well CHP is currently rated for specific topics such as Staying Healthy, Living with Illness, Access & Service and Qualified Providers.
The web-sites listed below provide additional quality report cards that you can use to evaluate healthcare providers.