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 the Board of Directors at least annually. It is distributed to applicable regulatory bodies and other stakeholders, as requested.
Paramount annually publishes three documents that describe the continuous quality improvement cycle.
- Quality Improvement Program Description: A comprehensive explanation of the health plan's Quality Improvement Program structure and composition, including accountability and reporting relationships; outlines resources dedicated to improvement activities. For a copy, go to our Quality Report page.
- Quality Improvement Work Plan: Documents the improvement process to be implemented in the calendar year through detailed performance goals and timetables, addresses clinical and administrative improvement activities throughout the organization and specifies operational accountability; offers rationale for project selection and task priorities.
- Quality Improvement Program Evaluation: Presents formal assessment of the outcomes of the prior year's quality improvement activities; compares results with baseline rates and benchmarks available at the time those activities were planned (two years prior); identifies barriers to success; includes recommendations for subsequent years.
Clinical Practice Guidelines
The Clinical Practice Guidelines are not intended to preclude clinical judgment and must be applied in the context of excellent clinical care, with adjustments for individual preferences, comorbidities, and other patient factors (i.e., Social Determinants of Health (SDOH), which when taken into consideration aid in the overall decision making into the plan of care for each patient). Because we want you to have easy, convenient access to our clinical practice guidelines, we have compiled them here.
- Cholesterol Management
- Chronic Heart Failure
- Chronic Obstructive Pulmonary Disease (COPD)
- Immunizations (all ages)
- Medical Record Review Policy
- Preventive Health (all ages)
- Tobacco Cessation Clinical Guidelines
- Tobacco Cessation Resources
These guidelines are adapted from nationally recognized sources such as the American Diabetes Association, the American Academy of Family Practice, the American Academy of Pediatrics, the National Heart, Lung and Blood Institute, and the Agency for Healthcare Research and Quality. Every year, our clinical practice guidelines are reviewed and updated by the Medical Advisory Council.