Quality Program

The Quality Program supports our commitment to ongoing quality care for our members. We have developed standards and performance goals and continue to monitor them to identify improvement opportunities.


Find helpful resources for your practice in these toolkits:

Use the tabs below to learn more about our Quality Program.

Accessibility and availability standards
Advance directives

Advance directives

To ensure our members' wishes are met concerning the provision of health care if the member becomes incapacitated and is unable to make those wishes known please comply with the following:

  • If the office has received a signed advance directive, a copy of the document must be prominently displayed in the patient's chart.
  • The office or facility should have copies of advance directives available for their patients to complete, or advise the patient how to obtain one from the hospital or his or her attorney.
  • If your office or facility is currently not meeting these standards, please take the steps necessary to ensure that members have access to quality care by complying with these standards.
HEDIS reporting
Provider advisory groups

Provider advisory groups

Our Provider Advisory Council (PAC) serves as a communication and advisory forum for participating providers, including primary care, medical specialties and behavioral health. PAC members practice in communities across our service area, provide input for some of our programs and collaborate with us on initiatives to improve care and services to members.

Provider Advisory Council (PAC)

The primary roles and responsibilities of the PAC include:

  • Providing input and feedback on services provided to members
  • Through discussion, participating in quantitative and qualitative analyses of Healthcare Effectiveness Data and Information Set (HEDIS®) and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) results and other quality measures
  • Providing input and making recommendations to the Quality Program Committee (QPC) about clinical quality and service improvement activities, including:

    • HEDIS results and improvement strategies
    • Members' access to providers and appointment availability
    • Medication prescribing and adherence measurement results
    • Clinical practice, behavioral health and preventive health guidelines
    • Coordination of care between medical and behavioral health care providers

PAC membership

Membership in the PAC represents a broad spectrum of participating primary and specialty care providers, including behavioral health. Appointments are made based on availability and need by specialty type. To learn more about becoming an active member of the PAC, please contact our Director of Quality.

The PAC meets at least semi-annually.

Site review standards

Quality Program participation and scope