Quality Management and Improvement Program Description Summary
Trillium Community Health Plan works to improve the health and well-being of our members. We do this with a focus on the member, community and local involvement.
Trillium supports the Triple Aim:
- Healthier and more satisfied Trillium members;
- A healthier community;
- More satisfied care providers; and,
- Lower costs for all.
The Quality Management and Improvement (QMI) Program helps Trillium meet this Aim. The QMI Program sets goals to make health care better in our community. To do this, we monitor the quality of many health care services, such as for minds, bodies, and teeth. We also look for ways to make them better.
What do we want to do?
- Make sure members get good care.
- Make getting care easier.
- Increase member safety.
- Meet members’ needs with special or complex care.
- Meet members’ needs from different backgrounds.
How are we going to do it?
- Gather members’ opinions.
- Look over complaints from members.
- Visit doctors’ offices.
- Set up care for members with special or complex needs.
- Make sure information is available in different ways to members.
- Measure how we are doing at these things.
What we did well last year* (2019):
- Helped members get the vaccines they needed – met the goal of 49% of children getting recommended vaccines by their second birthday.
- Helped members get their diabetes in control – met the goal of 54% of members with good control.
- Helped pregnant members get the care they needed – met the goal of 68% of women getting care after delivery.
- Helped members who were depressed get the medicine they needed – met the goal of 56% of members getting and taking needed medicine.
- Helped members have an appointment with a dentist – met the goal of 62% of members seeing a dentist.
What we need to focus on to do better this year (2020):
- Helping members get the right medicine for their COPD – did not meet the goal of 75% of members getting the right medicine.
- Helping members get tested for breast cancer – did not meet goal of 66% of women getting tested.
- Helping teen members get all their needed vaccines so they do not get sick – did not meet the goal of 38% of teen members getting needed vaccines.
- Helping doctors talk with child members about eating right and being active – did not meet the goal of 75% for eating right and 71% for being active.
- Helping members see the doctor every year – did not meet the goal of 85% of adult members having a visit.
What can you do to help us get better?
- Have a wellness visit every year.
- Understand your health problems and talk about what you want for your health with your doctor.
- Follow your doctor and pharmacist’s directions or ask for another choice.
- Fill out member surveys when you get them. Let us know what you think about the care you received.
You can call our Member Services if you want a full copy of our QMI documents. These include a Program Description, Work Plan, and Annual Evaluation. You can find our Member Services contact information under CONTACT US on our website.
*Based on Trillium (2020) HEDIS (Healthcare Effectiveness Data and Information Set) score and CAHPS (Customer Assessment of Healthcare Providers and Systems) results.