Quality Improvement Program

Our team is dedicated to ensuring our members receive quality healthcare services.

We have close partnerships with our network providers and long-term care facilities across the state of Arkansas. We also have dedicated nurse case managers assigned to each member to assist with care coordination needs. These partnerships and services allow us to better ensure our members receive the highest quality healthcare available to them.

We facilitate age-appropriate, evidence-based quality measures designated to us by the Centers for Medicare & Medicaid Services (CMS). These quality measures allow us to identify areas of success as well as areas for improvement. Quality measures are collected through multiple data sources. Below are examples of some of the important quality measures we track to ensure members receive excellent care.

Preventative Screening, Tests, and Vaccines

  • Breast Cancer Screenings for female members between the ages of 52-74
  • Colon Cancer Screening for all members between the ages of 50-75
  • Annual Flu Vaccine for all members of the health plan regardless of age

Managing Chronic Conditions

  • COPD Care Program: applies to members with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD)  

We offer a Disease Management Program that focuses on COPD management and education. Members with COPD can elect to participate in this program and will receive education about the condition and ways to help manage it.

Our team of case managers are available to assist each member in facilitating the care they need. If you would like to reach your case manager call 1-877-372-1033 (TTY 711) and someone will be happy to direct you to a nurse.