Quality Monitoring Programs
Our Quality Improvement Department works with the Maryland Department of Health. We do this to make sure our members get the best care. MedStar Family Choice participates in the following Quality Monitoring Programs:
- Healthcare Effectiveness Data & Information Set (HEDIS®): An annual audit of provider and plan compliance.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
- Satisfaction Surveys: The Maryland Department of Health conducts both Member Surveys and Provider Surveys every year. We track and share the results.
- Systems Performance Review: The Maryland Department of Health uses an outside company to review how MedStar Family Choice operates. It looks at all of our departments. It also evaluates the structures of our QI program.
- Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program: The Maryland Healthy Kids/EPSDT Program is for children 0-21 years. The program makes sure our child members are receiving quality health care.
- Quality of Care Review: MedStar Family Choice’s Quality Improvement Department reviews any issues between our providers and members. We do this to make sure our members are receiving the best possible care.
- Consumer Report Card: The Maryland Department of Health looks at all of the audits. They use the results to make a report card. It has the quality scores for the Managed Care Organizations. New members get this report card in their enrollment packet from the Maryland Department of Health. Current members also get the information when they re-enroll.