NY Manual
SHP Manual

SHP Provider Manual
6.3 Quality Review and Oversight | 7.2 Quality Assurance Performance Improvement (QAPI)

Section 7 - Quality Assurance, Performance Improvement and Compliance

7.1 Quality Assurance, Performance Improvement (QAPI) Plan and Compliance

The goals of the QAPI plan are to systematically monitor, evaluate and improve the quality and appropriateness of care provided or coordinated and to maximize member satisfaction. The following areas are reviewed annually:
  •  The quality of services provided to members;
  •  The management of care including availability, access and continuity, and early identification of problems;
  •  The identification and correction of operational and clinical practice issues;
  •  Outcomes in clinical and non-clinical areas as appropriate.
The Quality Improvement Committee (QIC), a multidisciplinary group comprised of Healthfirst clinical leadership, staff, and community providers, maintains oversight of the Healthfirst quality program. The QIC’s primary responsibilities are to promote initiatives and programs related to quality management and performance improvement, and ensure that Healthfirst has a rigorous quality oversight process. The Member Advisory Council, one of several sub-committees of the QIC, is a focus group that meets regularly to obtain feedback from members regarding the care and service they receive as Healthfirst members. QIC activities are reported to the Board of Directors.