QUALITY PROGRAM OVERSIGHT
Affordable and better care to promote better outcomes and a healthier population
Preventive care and successful management of chronic conditions can be hard to achieve for medically underserved communities. GHG is attuned to the Affordable Care Act’s National Quality Strategy that was designed to focus on patient outcomes as it relates to the delivery of services. We can assist organizations with the development of special programs that meet and exceed these and other standards.
In light of Medicaid’s large and growing coverage role, and the significant health care needs of its beneficiaries, GHG will be able to help managed care organizations, as well as states with developing models of care that assist with healthy behavior change, community partnerships, effective utilization management and staffing models to maximize member engagement. We can assist with conducting quality studies that focus on aspects of clinical and nonclinical services at a point in time relevant to future strategies.
Additionally, we will work with you to align and assess risk and prepare for clinical, quality and operational compliance audits pertaining to State, Federal and accreditation standards. We will ensure readiness through the review and development of policies and procedures, mock compliance assessment and effective regulatory communication. Our staff will help your plan develop, conduct and validate performance improvement plans along with validating performance measures.
By focusing on establishing compliance thresholds, developing standard oversight and monitoring policies and performing reviews your organization will be audit ready going forward.