Improving Quality at RMHP

Improving Quality at RMHP

The objective of the RMHP Quality Improvement Program is to monitor, measure, and take effective actions on identified opportunities to improve the quality and safety of health care and services through the cycle of objective evaluation, intervention, and reevaluation. These activities are the summation of efforts by several departments including Quality Improvement, Care Management, Pharmacy, Provider Network Management, Customer Service, Health Promotions, Claims, Home Health, Member Administration, Marketing, Information Technologies, and effective professional peer review. Pertinent activities from all of these processes are reported and integrated into the QI Program.


The goals of the RMHP QI Program are to:

  • Improve the quality of all categories of health care, including behavioral health care and chronic illness care, provided to the entire population of RMHP Members.
  • Promote clinical care and services that are delivered in a safe, timely, efficient, effective, equitable, and patient-centered manner.
  • Respond to the needs and expectations of RMHP internal and external customers by evaluating clinical and service performance relative to meeting those needs and expectations.
  • Encourage and engage in effective professional peer review.
  • Support and facilitate health care entities in geographically distinct areas in coordinating the collection and utilization of quality improvement information.
  • Evaluate and improve the effectiveness of the QI Program by developing action plans based on measured outcomes.
  • Report results of quality improvement efforts.
  • Ensure compliance with statutory requirements and accreditation standards.


Additional information about our Quality Improvement Program is available upon request. Please contact our customer service to request this information at 800-346-4643 or e-mail us.

Email Customer Service


HEDIS INFORMATION

 

RMHP CURRENT GUIDELINES


ADHD

 

Adult Preventive Care


Asthma


Cardiovascular Disease


Diabetes


Major Depression


Pediatric Preventive Care


Perinatal Care


Special Health Care Needs - Adults


Special Health Care Needs - Children


PROVIDER TOOLS

Helping our Members maintain a healthy lifestyle is a primary goal for Rocky Mountain Health Plans. We encourage our members to have regular well-care visits, to keep track of key health indicators, and receive preventive care. Below you will find:

  • Well-care guidelines for infants, children and adolescents, and adults.
  • Screening guidelines for breast cancer, Pap smears, prostate cancer, and colorectal cancer.
  • Guidelines for influenza vaccine, pneumococcal vaccine, and childhood immunization.
Rocky Mountain Health Plans participates in the Colorado Immunization Registry. Visit their website for more information.

View the links below for helpful information and self-management tools: