Monitoring Quality Management

QM Program

Our goal at Freedom Health 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 2018 HEDIS® (DOS 2017) results show that Freedom Health improved its performance and met quality goals in many HEDIS® measures. These areas include:

  • Adult Access to Preventive Services
  • Antidepressant Med Mgt
  • Rx in Rheumatoid Arthritis
  • Breast Cancer Screenings
  • Controlling Blood Pressure
  • Eye Exams for Members with Diabetes
  • Osteoporosis Management in Womeny
  • Use of High Risk Medications in the Elderly

Areas where we would like to improve our rates include:

  • Pharmacotherapy Mgt of COPD: Bronchodilator
  • 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 HEDIS® and Quality Measurement, go to:
http://www.ncqa.org/HEDISQualityMeasurement.aspx

You can also call Member Services at 1-800-401-2740.

Last Updated: 10/01/2018