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QUY TRÌNH ĐÁNH GIÁ VÀ CẬP NHẬT KẾ HOẠCH LÀM VIỆC

The Quality Management / Utilization Management (QM/UM) Work Plan is continuously evaluated, in order to determine the overall effectiveness of the Quality Management Program. The evaluation will result in an annual written report that includes: a description of completed and ongoing Quality Management activities; trending of measures to assess performance in the quality of clinical care and the quality of service; an analysis of whether there have been improvements in the quality of clinical care and the quality of service; and, an evaluation of the overall effectiveness of the Quality Management Program. The results of the Annual Quality Management / Utilization Management Program Evaluation are reported to the HealthChoices Program, the Counties, the Pennsylvania Department of Human Services, the Quality Management / Utilization Management Committees (QM/UMCs) and the Carelon Corporate Quality Council. Each year’s subsequent QM/UM Work Plan is constructed to reflect a continuous quality improvement process.