Quality Improvement Program

We are committed to the provision of a well-designed and well-implemented Quality Improvement (QI) Program. Our culture, systems and processes are structured around its mission to improve the health of all enrolled members.

Scope

The scope of the QI Program is comprehensive and addresses both the quality and safety of clinical care and quality of services provided to Ambetter from Arkansas Health & Wellness' members including medical, behavioral health, dental and vision care. We incorporate all demographic groups, care settings, and services in our QI activities, including preventive care, emergency care, primary care, specialty care, acute care, short-term care, long-term care (depending upon Ambetter from Arkansas Health & Wellness' products), and ancillary services.

Goals & Objectives

Our primary quality improvement goal is to improve members’ health status through a variety of meaningful quality improvement activities implemented across all care settings and aimed at improving quality of care and services delivered. Ambetter from Arkansas Health & Wellness continues to strive for outstanding quality outcomes.  As a new plan we have concentrated on providing an excellent provider network in 2015.  We continue to expand our network to meet our members' needs.

Credentialing Standards

For consideration to participate in the Ambetter from Arkansas Health & Wellness network, all licensed physicians and other licensed healthcare professionals who have an independent relationship with Ambetter from Arkansas Health & Wellness must complete an application for participation and submit copies of applicable supporting documentation.

Cultural Competency Plan

Ambetter from Arkansas Health & Wellness is committed to establishing multicultural principles and practices throughout its organizational systems of services and programs. That mission is supported by facilitating the process by which Ambetter from Arkansas Health & Wellness can respond to the health care needs of all individuals, regardless of their ethnic, cultural, religious beliefs or language. Our Cultural Competency plan will be reviewed and updated annually.

2016 HEDIS Guide

Practice Guidelines

Cultural Comptency Plan

LBP & AAB