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On June 20, 2024, UnitedHealth Group issued a press release offering an update on the Change Healthcare cybersecurity incident that occurred on Feb. 21, 2024. While the investigation to determine whose data is impacted is not yet complete, UnitedHealth Group has started the process to notify impacted customers and shared a website that provides additional information. UnitedHealth Group continues to offer credit monitoring and identity protection services, as well as a dedicated contact center to address questions. You can learn more about the support resources by visiting Change Healthcare Cyberattack Support and/or by reaching out to the contact center at 1-866-262-5342 with any questions.

Improving Health through Quality Improvement

Date: 08/22/24

Superior HealthPlan’s Quality Assessment and Performance Improvement (QAPI) Program aims to plan, implement and monitor ongoing efforts that demonstrate improvement in member safety and overall health-care experience. Superior’s goals and objectives for the QAPI Program include:

  • Member safety – Ensuring that the care provided does not harm members.
  • Member experience – Making sure members feel valued.
  • Efficiency – Helping providers use resources to maximize quality and minimize waste.
  • Eliminating disparities – Confirming quality care is reliably received regardless of geography, income, language, or diagnosis.

The QAPI Program addresses the efficiency and safety of clinically-delivered services and the quality of services provided and monitored by the Quality Improvement Committee (QIC). Providers have the opportunity to collaborate with Superior by volunteering with the QIC or one of its subcommittees. The QIC performs the following functions:

  • Provides continuous performance monitoring.
  • Identifies potential areas for improvement.
  • Improves care through viable interventions.
  • Analyzes the effectiveness of the interventions.
  • Solidifies goals to obtain quality outcomes at lower costs.
  • Enhances the quality of and access to care provided to members.
  • Collaborates with providers to develop and strengthen the patient care experience.

The QIC is also responsible for monitoring member outcomes through the Health Effectiveness Data and Information Set (HEDIS®). Rates are audited annually by a certified audit firm and submitted to the National Committee for Quality Assurance (NCQA). Throughout the year, Superior works to improve rates through member and provider interventions, data collection through claims and medical record reviews. Below is a summary of Superior’s 2024 HEDIS performance (Measurement Year [MY] 2023 in comparison with 2022 rates) for network providers.

HEDIS MEASURE

MY2022 Rate

MY2023 Rate

GOAL (QUALITY COMPASS 75TH PERCENTILE)

Appropriate Treatment for Upper Respiratory Infection URI

92.16%

91.22%

93.90%

Cervical Cancer Screening

62.29%

54.99%

61.80%

 

Childhood Immunization Status-Combo 10

 

31.39%

26.28%

37.64%

Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications

82.07%

84.22%

82.27%

Hemoglobin A1c Control for Patients with Diabetes- HbA1c <8

46.23%

52.80%

57.18%

Controlling High Blood Pressure

59.12%

60.34%

67.27%

Note: Superior requires all practitioners and providers to cooperate with all Quality Improvement (QI) activities, maintain the confidentiality of patient medical information and records, and allow Superior to use practitioner and/or provider performance data to ensure success of the QAPI program.

Superior’s Peer Review and Utilization Management committees and Performance Improvement team support QIC. For more information about: