Monitoring Quality Management

QM Program

Our goal at Freedom 1st Specialty Medicaid is to help our members improve their health by providing the best care and service options. In order to do this, we rely on our Quality Management (QM) program. The QM program monitors the quality of care given by Plan providers. The QM Program also looks for areas of service that need to be improved.

Measuring Success

Every year, we measure to see the progress we have made toward meeting our goals for healthy members. One of the tools we use to do this is called HEDIS®, which stands for Healthcare Effectiveness Data and Information Set. HEDIS® is a very common tool used by health care plans to see how well they are serving their members. We use these HEDIS® results to see where we need to focus our improvement efforts.

HEDIS® Results

Our 2016 HEDIS® results show that Freedom 1st Specialty Medicaid was able to report its progress as it strives to address its quality goals in many HEDIS® measures. These areas include:

  • AAP Adult Access to Preventive Services
  • Adult BMI Assessment
  • AMM Antidepressant Med Management
  • BCS Breast Cancer Screening
  • COA - Care for Older Adults
  • MPM - Monitoring for Pts on Persistent Meds
  • CBP Controlling High Blood Pressure
  • Comprehensive Diabetes Care
  • IET - Initiation of Alcohol and Other drug Dependence Treatment
  • AMB - Ambulatory Care
  • FUH Follow-up Hospital Mental Illness

 

You can view our full quality Health Plan Report Card at: https://reportcards.ncqa.org/#/health-plans/list

For more information on Agency defined HEDIS® and Quality Measures, go to: http://ahca.myflorida.com/Medicaid/quality_mc/submission.shtml

You can also call Member Services at 1-877-655-2424.

Last Updated: 07/11/2018