Quality in Action

Enhancing patient care through best practices

We're dedicated to empowering providers with the knowledge and tools necessary to improve patient outcomes. In this section, you can:

  • Discover how you can partner with us to elevate the standard of care and make a more meaningful difference in the lives of your patients.
  • Explore our best practices newsfeed, as well as links to our quality programs, toolkits and publications.

Best practices to improve patient care

August 2025

Screening for behavioral health conditions in primary care
We encourage PCPs to include behavioral health screening during both preventive and non-preventive encounters. To support PCPs, our Behavioral Health Toolkit includes screening tools and information about our broad range of in-network, virtual behavioral health providers.


July 2025

Childhood immunizations and timely vaccination
On-time vaccination throughout childhood provides immunity before children are exposed to potentially life-threatening diseases. As a provider, you are a trusted educator for parents and caregivers about the importance of following recommended vaccination schedules.


Closing a critical gap in antipsychotic care
We know that antipsychotic medications place patients at significantly greater risk for metabolic complications, particularly diabetes and cardiovascular disease. Metabolic monitoring requires additional coordination between primary care and psychiatry—coordination that too often breaks down, leaving patients at risk.


Convenient care options to optimize UTI care
As we continue to prioritize our members' health and well-being, we want to highlight the various care options available to them for quickly and effectively addressing urinary tract infections (UTIs). Leveraging these convenient alternatives can reduce unnecessary emergency room visits and ensure the right care at the right time.


eGFR and uACR testing in diabetes care
Completing estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR) testing with dates of service four days or less apart can significantly impact patient outcomes.


Getting ready for flu season
Tips to consider for your patients as we approach flu season.


National Immunization Awareness Month
August marks National Immunization Awareness Month (NIAM), which highlights the critical importance of routine vaccinations across all age groups. As a provider, your role in promoting immunization is invaluable to community health.


May 2025

Help increase post discharge care rates
Members who see a behavioral health clinician within seven days of discharge have improved outcomes. Care coordination and telehealth can help you ensure members receive timely care.


Supporting wellness through routine checkups
Learn how to support patient wellness through regular checkups and preventive screenings, as well as tips for billing annual wellness visits.


Test result follow-up processes impact patient satisfaction
Small changes in test result management can lead to big improvements in patient satisfaction, safety and practice efficiency.


April 2025

Maximizing the impact of well-child visits
Explore resources to enhance the well-child visit experience and improve outcomes for your patients.


Prioritizing women's health
Learn about the preventive care services we cover, areas of focus (cervical cancer screening, chlamydia screening, maternal health) and resources for you and our members.


March 2025

Cancer screenings and prevention
View the list of preventive services, including cancer screenings, we cover at no cost (no copay and no deductible) to our members.


Improving members’ experience with medications
Understand factors that may affect your patients’ ability to take medications as prescribed or easily obtain prescriptions.


Resources for addressing social determinants of health
Learn about best practices and access resources to address social determinants of health (SDoH).


Taking control of tomorrow: National Healthcare Decisions Day
Having advance care planning (ACP) conversations with your patients can help them align their medical care with personal values and wishes. We support these crucial discussions by reimbursing for ACP conversations with members, regardless of age or health status.


Tobacco cessation resources for providers and patients
Help patients decrease tobacco use by sharing and encouraging them to use tobacco cessation tools and resources.


Programs

Quality Program

When you share cost and quality data with our members—your patients—they can make more informed health care decisions. Our cost and quality tools and resources support our commitment to ongoing quality care for our members.

Explore our Quality Program

Quality Incentive Program

Earn incentives when you partner with us to address gaps in patient care, focus on delivering an outstanding member experience and submit high-quality data resulting in improved health outcomes for our Individual on-exchange members.

Resources

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Health Equity Toolkit

Resources to develop and improve your cultural competency and health literacy practices.

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Quality Improvement Toolkit

Resources to help you improve the member experience and patient outcomes.

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Behavioral Health Toolkit

Support for PCPs, behavioral health clinicians and members.

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Quality Measures Guide

Learn about the quality and member experience measures that we track for various programs and annual reporting. This guide includes specifications for measures.

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Provider News

Read our newsletter for updates about our quality programs, tools and resources to improve patient care. Subscribe to stay up to date.