46
QUALITY IMPROVEMENT PROGRAM
Bravo Health is committed to providing access to quality healthcare for all Members in all product
lines through the continuous study, implementation and improvement of care to our Members. Quality
Improvement (QI) assumes that there is no permanent threshold for good performance. Our Members
expect and should be provided a comprehensive and therapeutic health care delivery system that is
always evolving and improving.
The Quality Improvement Department accomplishes this by integrating, analyzing, and reporting on
data from across the Plan as well as other data sources. The QI Department prioritizes quality
initiatives based on relevance to the Plan. QI works with internal Bravo Health departments to manage
plan resources in the most cost effective manner to maximize patient health outcomes. The following
is a brief overview of the QI Department’s functions.
The QI Department works on internal and external reporting of quality of care and risk management
concerns. Substantial QI/Risk Management is presented to the Quality Improvement Committee
(QIC) to formulate corrective action plans and monitor the results.
The QI Department assists Senior Management and the Medical Director in the coordination of the
Quality Improvement activities. The QIC is charged with providing oversight (identification,
prioritization, and coordination) of all quality improvement activities related to the care and service of
our Members.
The QI Department coordinates with various internal departments on mandatory Centers for Medicare
and Medicaid Services (CMS) audits such as Healthcare Plan Effectiveness Data and Information Set
(HEDIS) and The Health Outcomes Survey (HOS). QI also contributes to Bravo Health’s annual CMS
site visit and quality reviews by the Pennsylvania Department of Health.
The QI department works to maintain optimal health outcomes for our Members through annual
review of best practice standards. Preventive standards are derived from The United States Preventive
Services Task Force Standards (USPSTF), which are derived from the American Diabetes
Association, the American Cancer Society as well as other nationally recognized organizations.
Guidelines are revised and modified to reflect the latest in preventive best practices.
If you have any questions about Bravo Health’s Quality Improvement Program, or would like a
comprehensive description of The QI Program, QI Program Annual Goals, or a list of activities
towards achieving those goals, please feel free to contact Bravo Health’s Quality Improvement
Department at:
Bravo Health, Inc.
3601 O'Donnell Street
Baltimore, MD 21224
Information will be provided upon request.
