Promoting Quality and Safety by Empowering our Members
We empower our members to take an active role in their care and the care of their families. We urge them to ask questions, understand conditions and treatments and evaluate options. We assist members in:
- Choosing quality doctors and hospitals
- Accessing health information
- Following health and immunization guidelines
Improving Quality of Care and Patient Safety through Partnerships
Provider Network—We know that improving healthcare quality is a team effort. That’s why our network includes some of the best doctors and hospitals in the state. We review Primary Care Provider (PCP) medical records periodically for compliance with standard medical record-keeping, documentation and standard medical practices.
Pharmacy Network—Prescriptions filled by QualChoice members at Optum-participating pharmacies are screened for safety and appropriateness. Factors considered include: drug-age conflict, drug-drug interaction, drug-pregnancy conflict, drug-disease conflict, late refill, refill too soon, therapeutic duplication, low daily dose, excessive use and high daily dose.
Organizational Collaboration—QualChoice collaborates with national organizations aimed at increasing patient safety, including: