Always improving on quality

Priority Partners wants plan members to have the best health care services. We are always checking the services we provide to make them better.

What Are Our Focus Areas?

We use national measures and best practices to make sure that our members get the best care and services. Our Quality Improvement (QI) staff focuses on four areas:

      • Organizational quality
      • Service excellence
      • Quality of care and member safety
      • Business process improvement

How Often Are We Graded?

QI is always looking at data and trends. We have many projects and plans in place. These projects are graded every year. We use the results to set goals for the next year.

2018 Quality Improvement Highlights and Rankings:

      • Commendable Accreditation status through National Committee for Quality Assurance (NCQA®)
      • Rated 3.5 out of 5 with Commendable Accreditation
      • The highest possible percentile ranking (NCQA 90TH percentile) for the following HEDIS measures:  Appropriate Testing for Children with Pharyngitis, Childhood Immunizations (Combo 1 and Combo 10), Immunizations for Adolescents (Combo 1) and Postpartum Care. View the full HEDIS results.
      • NCQA® HEDIS® auditor recognition and audit SEAL for 2018 HEDIS®
      • Member “Rating of Health Plan”, “Rating of Health Care”, “Rating of Personal Doctors”, “Rating of Health Plan” and “Coordination of Care” composites met the 75th percentile accreditation benchmark as measured by the annual member satisfaction survey. View the 2019 Member Experience Survey (CAHPS).

Check out our Health Plan Performance Card.

Where Can I Find Out More About Quality Improvement?

You can find more information about our quality improvement efforts in the “Your Health Matters” newsletters.