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Quality Improvement Program

The Quality Improvement (QI) Program is an important part of PA Health & Wellness.  The program creates plans, puts those plans into action, and measures efforts to improve your health and safety. 

The QI Program monitors the quality of care and services provided in the areas below:

  • Making sure participants get the care they need, when and where they need it
  • Making sure that members are receiving quality care
  • Cultural needs of our participants
  • Participant satisfaction
  • Patient safety and privacy
  • Offering a wide variety of provider specialties
  • Health plan services members are using 

The goal of the QI program is to improve member health, safety, and satisfaction. This is achieved through many different activities. Some of our Quality Improvement goals include the following: 

  • Good health and quality of life for all participants
  • Care provided by the Health Plan’s Providers meets industry-accepted standards of care
  • Participant services meets industry-accepted standards of performance
  • Provide participants with Preventive Care reminders annually
  • Participant experience will meet the Plan’s expectations
  • Compliance with all State and Federal laws and regulations
  • Evaluate the quality of health care by looking at certain performance measures
  • Participant satisfaction meets PA Health & Wellness’ targets

For questions about the QI Program and our progress on meeting goals, call Participant Services at 1-844-626-6813 (TTY/TDD 1-844-349-8916).

The QI Program also reviews services provided to our members. We have clinical practice guidelines for certain conditions. If you would like a copy of these guidelines or need more information about programs call us at 1-844-626-6813 (TTY/TDD 1-844-349-8916).

Information and/or a full copy of PA Health & Wellness's QI Program Description is available by request by calling Participant Services at 1-844-626-6813 (TTY/TDD 1-844-349-8916).