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Quality Improvement

Maryland Physicians Care has a Quality Management (QM) Program. The QM Program monitors and assesses the health care services delivered to our members. The goal is to deliver high-quality care and services to all members.

Every year Maryland Physicians Care measures our progress against goals. We measure all parts of the QM Program. That includes clinical and service activities like:

  • Promoting health care safety with member and provider education.
  • Establishing preventive health guidelines and clinical practice guidelines. These help members understand what kind of services they need and how often they’re needed
  • Making sure members have access to qualified health care professionals.
  • Evaluating the quality of care members receive. We look at data known as the Healthcare Effectiveness Data and Information Set® (HEDIS). That info helps us see if members are receiving appropriate preventive care. Examples of preventive care:
    • Annual flu shots
    • Child immunizations (shots)
    • Eye tests
    • Cholesterol tests
    • Prenatal care for pregnant women
    • Evaluating member quality of care concerns and take action if needed
    • Conducting surveys to see if members are satisfied. Example: The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey:
      • The survey is mailed to members every year to complete and send back.
      • The survey helps us see how happy or unhappy members are with their care and doctors.
      • The survey helps us find areas to improve.

For more information about our Quality Management Program, please contact Member Services at 1-800-953-8854.

MEMBER SATISFACTION SURVEY

2021 Satisfaction Survey Results (PDF)

2021 GOALS (QIP)

Listed below are some of our areas of focus and goals for 2021:
  • Increase member satisfaction results from 2020
  • Ensure that the provider network has sufficient numbers and types of primary care and specialty practitioners so that members have access to care as needed
  • Increase the rate of members who receive lead tests on schedule
  • Reduce the number of members using high dose opioids
  • Increase the number of pregnant members who get their post-partum exam on time
  • Increase the number of members who have at least one well visit with a primary care doctor
  • Increase the number of adult women who complete breast cancer screening as recommended
  • Increase the number of members who use asthma controller medication
  • Ensure that members are connected to Case Management services to assist with coordination of care
  • Continue health and wellness promotion activities through
    • Placing helpful information and health education on MPC’s website
    • Providing a quarterly newsletter
    • Using social media (face book) to post health information
    • Sending letters, post-cards, and texts to remind members of important due dates of services
    • Holding community events to connect with members

2020 ACCOMPLISHMENTS (QIP)

Listed below are some of our 2020 accomplishments:
  • Increased rates in 11 HEDIS measures
  • 5/5 Star Rating in Getting Care Quickly Composite – Adult CAHPS Survey.
  • 4/5 Star Rating in Getting Needed Care Composite – Adults CAHPS Survey.
  • 5/5 Star Rating in Getting Care Quickly Composite – Child CAHPS Survey.
  • 5/5 Star Rating in Getting Needed Care Composite – Child CAHPS Survey.
  • Increased Maryland Department of Health’s Custom Lead Screening measure rate significantly
  • Exceeded the goal for the Opioid Quality Improvement Activity of 5% reduction of members using high dose opioids.
  • Improved the turnaround times for preservice, inpatient, and post service decisions and notifications therefore assisting with timely access to care.

2020 GOALS (QIP)

Listed below are some of our areas of focus and goals for 2020:
  • Meet or exceed member satisfaction results from 2019
  • Ensure that the provider network has sufficient numbers and types of primary care and specialty practitioners so that members have access to care as needed
  • Improve the rate of members who receive lead tests at one year old
  • Continue to work with local organizations to address the Opioid epidemic
  • Maintain the low number of members who are readmitted to the hospital
  • Increase the number of pregnant members who get their post-partum exam
  • Decrease the number of unnecessary Emergency Room Visits
  • Increase the number of SSI Adults and Children who have at least one office visit with a network provider
  • Continue health promotion activities by
    • Placing helpful information and health education on MPC’s website
    • Providing a quarterly newsletter
    • Using social media (face book) to post health information to promote health
    • Sending letters, post-cards and texts to remind members of important due dates of services
    • Providing community events to promote health

…and much, much more!

Know The Facts About Coronavirus (COVID-19)

Symptoms are flu-like, including: fever, coughing, and shortness of breath.

If you think you might have been exposed, contact your doctor immediately. You can also have a video visit with a doctor using the MyVirtualMPC app.

It is important to do everything you can to protect yourself from COVID-19.