Quality Management and Improvement Program Description Summary
Trillium Community Health Plan (Trillium) is a company helping people who live in Lane County, the city of Reedsport and surrounding areas by providing health plans in Oregon. Trillium works with many kinds of doctors to help improve the health and well-being of its members.
Trillium supports the Triple Aim:
- Better care for Trillium members;
- Better health for the community; and,
- Lower costs for all.
The Quality Management and Improvement (QMI) Program helps Trillium meet the Triple Aim. The QMI Program sets goals to support Trillium’s work to make health care better in our community. The program checks many health care services, such as for bodies, minds and teeth. The program also looks 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* (2018):
- Helped members who were depressed get the medicine they needed and kept taking it – met the goal of 70% of members getting needed medicine
- Helped members with heart disease get the right medicine – met the goal of 85% of members getting the right medicine
- Helped members get their diabetes in control – met the goal of 53% of members with good control
- Helped members get the care they needed – met the goal of 75% of members getting care they needed
What we need to focus on to do better this year (2019):
- Helping members get the right tests for lung disease – did not meet the goal of 36% of members getting the right tests
- Helping teen members see the doctor every year – did not meet the goal of 59% of teen members getting wellness visits
- Helping children get tested for lead in their bodies – did not meet the goal of 90% of children tested
- Helping doctors talk with child members about eating right and being active – did not meet the goal of 76% for eating right and 67% for being active
- Helping teen members get all their needed shots so they do not get sick – did not meet the goal of 85% of teen members getting needed shots
- Helping members to get tested for breast cancer – did not meet goal of 65% of women getting tested
What can you do to help us get better?
- Have wellness visits every year.
- Understand your health problems and talk about what you want for your health with your doctors.
- Follow your doctors’ and pharmacists’ directions or ask them 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 are documents about our Quality program. They 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 2018 HEDIS (Healthcare Effectiveness Data and Information Set) score and CAHPS (Customer Assessment of Healthcare Providers and Systems) results.