USA MCO Continuous Quality Improvement initiative

At the core of healthcare lies the need to continuously focus on offering quality healthcare in an affordable and effective manner. USA has developed a Continuous Quality Improvement initiative with the details listed below. Please contact us if you have any questions or require additional information.

• Apply CQI approach to consolidate services, minimize overhead and deliver a competitive product to the marketplace.

• Educate contracted practitioners and facilities in CQI procedures.

• Maintain national network accreditation standards.

• Maintain a network-wide CQI plan.

• Develop highest quality human resources/management function.

• Use comparative data to measure staffing levels and establish future staffing projections.

• Document “protocols” for problem management based on proven efficient success.

• Evaluate staffing levels on an ongoing basis in view of cost effective outcomes.

• Increase employee participation in decision making and planning processes.

• Improve, measure and promote a quality healthcare system.

• Identify appropriate benchmarks for outcomes and use them as a measurement.

• Escalate CQI efforts with emphasis on strategic planning and redesign of certain processes in addition to incremental changes.

• Educate all employees about customer-focused planning and CQI measures.

• Promote employee education, skill enhancement and salary ramps to retain intelligent, skilled employees and use as recruitment tools.

• Benchmark with other integrated delivery systems for processes that reduce expenses.

• Continually improve upon all elements as an integrated network.

• Continuous education of all network constituencies (board, management, employees, practitioners, components, purchasers) about CQI philosophies.

• Encourage network providers to adhere to JCAHO’s National Patient Safety Goals.

• Development of outcomes measurement in A&H and Workers’ Compensation environments.

• Enhance cutting-edge reimbursement methodologies for practitioners and components to offer the most competitive managed care products in the market.

• Maintain HIPAA compliance and enhance state of the art EDI capabilities.

• Maintain Workers’ Compensation Healthcare Network Certification.


USA Managed Care Organization

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