HCA375- Week 3- Discussion 1

See Attachment- Please note i am a HEDIS Expert in my current position and this needs to be great.

CQI Models

After reading Chapter 1 through 4, you should be familiar with quality improvement initiatives including the National Committee for Quality Assurance (NCQA) HEDIS & Quality Measurement: HEDIS Measures (Links to an external site.)Links to an external site.. Health plans and physicians must ensure they are meeting standards set by the accreditation agencies, such as NCQA. As a physician practice manager for Dr. Jones, you have just conducted a mock survey of the patient chart data. The data shows that your physician practice is not meeting standards for two HEDIS measures.

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Introduction: In the field of healthcare, quality improvement initiatives are crucial in ensuring the provision of high-quality care to patients. One of the well-known accreditation agencies is the National Committee for Quality Assurance (NCQA). NCQA has developed quality measures, including the HEDIS measures, which health plans and physicians must comply with. In this task, we will be discussing CQI models and how they relate to the HEDIS measures.

Answer: Continuous Quality Improvement (CQI) models are crucial in healthcare to ensure that healthcare providers continuously monitor and improve their processes and outcomes. As a physician practice manager for Dr. Jones, it is imperative to evaluate and analyze the patient chart data continuously. The mock survey conducted indicated that the physician practice failed to meet standards for two HEDIS measures. Therefore, it is necessary to engage in a CQI model that focuses on quality improvement in these specific areas. This can be achieved by implementing process improvement initiatives such as education and training for providers and staff, evaluating current processes to identify gaps and implement action plans to address these gaps. By employing a CQI model, the physician practice can ensure compliance with the NCQA standards and improve patient care outcomes.

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