Quality management

We want our members to receive high-quality care. We do this through our Quality Management program which supports our integrative member health care approach that addresses medical needs along with mental health and social needs like housing, food and transportation.

Our Quality Management program is reviewed every year to measure impact and to make sure we are meeting regulatory standards and guidelines. We use learnings to help us develop and prioritize new strategies, and to track progress toward current goals.

Our Quality Management program: 

• Improves member health
• Ensures members have access to needed, appropriate care
• Helps to achieve and maintain member satisfaction
• Ensures that our health care is fitting, available and meets community quality
• Helps us make continued performance improvement measured by standard methods
• Allows us to address health care disparities through activities

Together with our providers and community partners, Hennepin Health coordinates quality, culturally-aware care to members.

Learn more: Contact Member Services at 612-596-1036 for a copy of the current Quality Management program description or report.

What members can do

• Get annual wellness checkups, screening and shots.
• Discuss and monitor your physical and mental health with your doctor.
• Follow the treatment plan recommended by your doctors and providers.
• Complete and return all member surveys.
  
  

The Hennepin Health Healthwise® Knowledgebase has information and videos about nutrition, illnesses and how to stay healthy. 

What we are doing

Our Quality Management program is dedicated to improving member health and care. We aim for repeated improvement of our health plan services and seek to be a leader in eliminating health care disparities. We want our members to have the best health care access and delivery as set by community and Minnesota standards.

We encourage:

• Full participation in medical treatment
• Providing treatment in the least restrictive way possible
• Delivery of medically necessary care
• Proper and efficient use of available resources
• Preventive health services
• Health education
• Avoiding unnecessary medical treatment or expenses

Here are some of the ways we are working on quality care.

Member satisfaction

The Centers for Medicare & Medicaid Services (CMS) and Department of Human Services (DHS) do an annual survey called the CAHPS (Consumer Assessment of Healthcare Providers and Systems) to measure member satisfaction with our plans. 

Read the 2021 PMAP CAHPS report (PDF) 

Read the 2021 SNBC CAHPS report (PDF)

Plan performance

We use standardized performance measures to provide members, consumers and providers with the information they need for a reliable comparison of our health plan. These standards are called Healthcare Effectiveness Data and Information Set (HEDIS).

Read the 2021 HEDIS Summary - PMAP/MinnesotaCare  (PDF) 

Read the 2021 HEDIS Summary - SNBC (PDF)

Population Health Management Programs and Services

Population Health Management (PHM) is an integral part of Hennepin Health. It focuses on increasing member health care quality and value by improving preventive or chronic disease care and care coordination for members with complex medical and social needs.

The program is tailored to help you feel as good as possible no matter your health status. Programs and services work with you in your own space. The program encourages you to have a primary care provider who assists you in your care and addresses other issues like housing and food insecurity. 

Our programs help you:

• Stay healthy through wellness and prevention initiatives.
  - Childhood immunizations up to age 2
  - Adolescent immunizations ages 11-13

• Manage emergent health risks.
  - Prenatal and postpartum care for pregnant individuals
  - Diabetes management for members living with diabetes

• Have safe, healthy outcomes as you move between health care settings.
  - Focus on members who are hospitalized with housing insecurity and/or substance use concerns

• Assist you in managing chronic illnesses.
  - Complex case management

If you would like to participate in the PHM programs or want more information, call us at 612-596-1036, TTY 711.

 

More quality initiatives

 

Clinical practice guidelines

Clinical practice guidelines describe appropriate care based on the best available scientific evidence and broad consensus. Their use promotes best practices, reduces variation in clinical practice that does not provide value, reduces disparities and encourages efficient use of resources.

Go to our clinical practice guidelines webpage.

 

DHS approved 2/27/2023; QM-1416-MC

 

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