Health Plan of Nevada

Health Plan of Nevada 2020 Quality Improvement Workplan
for Commercial Members
Health Plan of Nevada prepares a workplan each year that shows the quality projects that are in place. Health Plan of Nevada’s 2020 Quality Improvement Workplan spotlights projects that help maintain the quality of health care and services for health plan members. Key Focus Areas in the 2020 Quality Improvement Workplan: • Adult Health • Child and Adolescent Health • Women’s Health • Management of Chronic Conditions • Behavioral Health and Substance Abuse • Customer Service • Member Satisfaction • Patient Safety • Access & Availability
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Health Plan of Nevada

2020 Quality Improvement Workplan

Project Name

Key Objectives/Activities

Adult Health

Colorectal Cancer Screening Continue to improve the colorectal screening rate for members aged

50 to 75 years old.

Adult BMI Assessment

Improve the documentation of BMI assessment at outpatient visits in

adults’ aged 18 to 74 years old.

Child and Adolescent Health

Children & Adolescent Access Improve the number of children & adolescents ages 1-19 years old

to Primary Care Practitioners who had a PCP visit.

Well-Child Visits

Improve the rates of well child visits and well care for children and

teens.

Women’s Health

Breast Cancer Screening

Improve the breast cancer screening (e.g., mammogram) rate for

women aged 50 to 74 years old.

Management of Chronic Conditions

Comprehensive Diabetes Care • Improve care for members aged 18 to 75 years old with diabetes.

• Improve the numbers of members who receive hemoglobin

A1c tests, eye exams, and control their blood pressure.

Behavioral Health Follow-Up After Hospital Stays for Mental Health Issues Member Satisfaction Member Satisfaction
Patient Safety Patient Safety

Improve follow-up care for members aged 6 years and older who were hospitalized for treatment of select mental health disorders.
• Improve members’ satisfaction with the health plan. • Look at members’ satisfaction with programs designed to help
them stay well including the Disease Management Program and the Case Management Program.
• Educate health plan members about medication safety. • Monitor providers’ medical records for compliance with
standards and privacy laws. • Assess member satisfaction using complaints/appeals and
satisfaction data to identify opportunities for improvement. • Work with health care providers to improve the discussions
between health care providers and members. • Improve the coordination of care between primary providers
and other providers such as hospitals, home health agencies, skilled nursing facilities and surgical centers. • Facilitate activities to increase cultural competency in all areas

Practitioner Availability Practitioner Availability

Ensure that health plan members have access to medical and behavioral health care providers for routine, urgent and after hours care in all service areas.

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