Information about our Quality Program

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The Quality Management (QM) Program ensures that our members experience the best health outcomes possible when receiving physical and behavioral healthcare services. This includes collaborating with our provider network to focus on the safety of our members’ care. By continually working to improve quality, the QM Program establishes high standards of evidence-based medical practice in the community, prioritizes member health and safety, and works to improve member and provider satisfaction. This process helps ensure our members receive high-quality care that improves their health. It also positively impacts the health of our community. The Blue Cross QM Program goals are to:

  • Perform quality improvement and assurance activities in alignment with our corporate mission, goals, and strategies.
  • Improve quality, safety, and coordination of care for our members receiving physical and behavioral healthcare services.
  • Integrate physical and behavioral healthcare to improve the quality of care delivered to our members.
  • Continuously promote and monitor evidence-based best medical practice across our network of providers.
  • Collaborate with community partners to achieve improved care for all Blue Cross members.
  • Improve the quality of member and provider engagement and satisfaction with the health plan, including access to care.
  • Identify our members’ varied cultural and linguistic needs to offer a diverse range of services, which provide meaningfully improved care to our members and support our providers’ care for members.
  • Improve the cost, quality, and efficiency of service delivered to members and providers.

Members can view the Goals of the QM Program and our progress toward meeting these goals in the 2016 QM Program Evaluation.

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