Identify five (5) clinical or service quality studies an HMO might conduct.

Quality studies, a key quality management process, are routinely completed on clinical and service issues and are required by the various accreditation agencies. Some examples include the following: analysis of member complaints, clinical study of readmissions to the hospital within four weeks, and drug usage for hypertensive patients.

Essay Due Soon? Let Our Experts Help You Beat the Deadline!

Tell us about your assignment and we will find the best writer for your paper. Our Essay writing service covers over 243 courses and programs, catering to your specific needs.

Write My Essay For Me!

Identify five (5) clinical or service quality studies an HMO might conduct. Explain why they would be helpful to the quality improvement process of the HMO. You may contact a local HMO and query the quality management director.

Solution Preview 

The Health Care Service Corporation (HCSC) Mission is “To promote the health and wellness of our members
and communities through accessible, cost-effective, quality health care.”
Vision HCSC Key 2010 Vision Points HCSC has recently published an update of its long-range strategic plan, 2010 Vision, which BCBSIL has incorporated into its own strategic design. The following are the five key 2010 Vision Points for HCSC: Champion the non-investor-owned (NIO) model, Be responsive to our employee, member and community needs by promoting health and wellness as evidenced by demonstrable and measurable improvements in outcomes (clinical, satisfaction, and financial). Provide unrivaled, differentiated customer service for members, providers, employers and producers, Become an industry leader in providing valuable information to ourselves and our customers, Achieve significant growth to 20 million members
In 2008, Blue Cross and Blue Shield of Illinois (BCBSIL) will continue to focus improvement efforts on business
areas that are important to our customers in a manner consistent with the HCSC values and goals. The BCBSIL
2008 Quality Improvement (QI) Program and Work Plan link HCSC strategic initiatives and goals with Blue Cross
and Blue Shield of Illinois (BCBSIL) performance improvement activities. The intent is to facilitate the
development of corporate and leadership values within BCBSIL.The BCBSIL philosophy is to provide products and services of the highest quality and value with a direct focus on meeting the needs of customers. The BCBSIL Quality Improvement program is based on a view that the process for delivery of medical care and
services can be continuously improved. Monitoring and evaluation are an integral part of the managed care
quality improvement process by revealing opportunities for positive change that can benefit both members and
health care practitioners. Through the QI program, we aim to help…