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Quality Improvement

AmeriHealth Caritas VIP Care Plus has a Quality Improvement (QI) program to make sure health care and services our members receive are:

  • High quality.
  • Safe.
  • Right for the members' needs.
  • Efficient.
  • Effective.

We help our members avoid preventable disease, manage chronic illnesses and disabilities, and maintain or improve health and quality of life.

We review our QI program each year to see how we are doing. This review includes suggestions for improvement and setting goals for the next year.

Our mission is to help people get care, stay well, and build healthy communities. The Quality team supports this mission by checking on the health care and services members receive. We help with:

  • Health and disease management programs for members in a manner that meets the cultural and language needs of our members
  • Outreach to members to help them get the care and health education they need
  • Programs to serve our members who have special health care needs
  • Continuity and coordination of care
  • Member and provider surveys and using the responses to improve our services
  • Reviewing the quality of care and services given by AmeriHealth Caritas VIP Care Plus medical, dental, vision, and pharmacy providers
  • Access to and availability of care and services

In 2017, improvement occurred in these measures:

  • Controlling blood pressure
  • Diabetes care
  • Access to ambulatory health services

In 2018, the Quality team will continue to:

  • Improve member health outcomes
  • Reduce gaps in care
  • Improve access to care and services
  • Increase coordination of care

Call Member Services at 1-888-667-0318 (TTY/TDD 711), seven days a week, 8 a.m. – 8 p.m., if you would like to learn more about our QI program and its goals, activities, and outcomes.