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Quality Program and Reports

It is inherent to Paramount’s philosophy that quality improvement is not the responsibility of any single individual or department, but the duty of every employee and contracted provider.  Paramount is committed to using a continuous quality improvement cycle in managing all clinical and administrative services.  Clinical monitors address all demographic groups, care settings and types of service.  Indicators of performance are measured across all pertinent products, reaching beyond the assurance of high quality care and service.  Paramount is also dedicated to satisfying customer expectations, and to respecting all people by listening to and supporting them. 

Purpose

The Quality Improvement Program provides a formal process by which Paramount and its participating providers and practitioners strive to continuously improve the level of care and service rendered to members and customers.  It utilizes objective and subjective indicators to measure and evaluate the quality and safety of clinical services provided to members.  The program addresses both medical and behavioral health care, and the degree to which they are coordinated.  It defines the systematic approach used to identify, prioritize and pursue opportunities to improve services, and to resolve identified problems.  The Quality Improvement Program is reviewed, updated and approved by the Medical Advisory Council and forwarded to the Board of Directors at least annually.  It is distributed to applicable regulatory bodies and other stakeholders, as requested.

Objective 

Specific program objectives have been developed to guide quality improvement activities.  The objectives of the Quality Improvement Program, as approved by the Board of Directors are as follow.

  • To continuously improve the caliber and delivery of clinical and administrative services to Paramount customers through systematic monitoring of critical performance indicators, identifying barriers to improvement, and implementing specific strategies to improve processes and outcomes
  • To annually evaluate the efficiency and effectiveness of the Quality Improvement Program, including its structure, methodology, and results
  • To evaluate at least annually the efficiency and effectiveness of performance from any subcontracted agents or service providers, also known as delegated entities
  • To assure that all members are treated with dignity and respect, and are provided with appropriate, understandable education and information to accept responsibility and actively participate in personal health care decisions
  • To use evidence-based guidelines as the basis for all clinical decision-making
  • To support public health goals, as appropriate for the populations served, by integrating them into clinical quality improvement activities
  • To maintain regulatory compliance related to Paramount quality assurance and performance improvement activities
  • To cultivate comprehensive patient safety practices among Paramount providers and staff, including coordination of care
  • To identify disparities in health care delivery to members, and intervene to reduce them by delivering culturally and linguistically appropriate care and services

For more information about the Paramount Quality Improvement Program, contact Member Services or send us an e-mail at PHC.Quality@ProMedica.org

Quality Reports

The Quality Report contains results for the HEDIS® Effectiveness of Care measures as well as the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey for members. To help us know how we are doing, Paramount reports information about the care, treatments and satisfaction levels of our members through a few key mechanisms. These mechanisms include HEDIS® and CAHPS®.

Below, you will find a link to Advantage, Commercial and Elite reports. The Commercial and Elite reports highlight some programs and interventions that have helped to improve rates. These reports also show Paramount’s rate as compared to the National Committee for Quality Assurance (NCQA) accreditation benchmarks in clinical care and member satisfaction. Please take a moment to evaluate the information. The broader your knowledge base, the easier it will be for you to make those crucial decisions regarding health care coverage.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA)

CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ)

  • Advantage Quality Report  (2016)
  • Commercial Quality Report  (2016)
  • Elite Quality Report  (2016)