We are committed to improving the quality of health care for all NHP members.
NHP's mission is to promote the health and wellness of our members, and to help ensure equitable, affordable health care for the diverse communities we serve.
We work to continuously improve managed care systems that are member-focused, quality-driven, community-based, culturally-responsive, and financially-viable in contemporary and future care environments.
What do we do to promote quality with our providers?
NHP recognizes that quality care can only occur with quality providers. That is why our network includes some of the best doctors in the state and some of the leading hospitals in the world.
To maintain the highest standards of care for our members, we conduct the following quality control programs:
- Annual Medical Record Reviews – Annually, NHP randomly selects PCPs and conducts Medical Record Reviews of their medical records. This is done to assess their compliance with our standards for privacy and other criteria for medical record keeping.
- Patient Satisfaction Surveys – NHP conducts Patient Satisfaction Surveys at practitioners' offices to learn about member satisfaction with urgent and routine care. These surveys form a basis to offer financial incentives to practitioners in our Pay for Performance Program to promote and award practitioners' achievements in service to members.
- Pay for Performance – NHP's Pay for Performance Program is focused on prevention, disease management, and member satisfaction. It is designed to improve the care of members. Financial incentives for providers are used to recognize improvement as providers work towards performance goals. Participating providers are measured against National Committee for Quality Assurance (NCQA) and New England Regional quality standards, as well as NHP 'best achievable' practices. NHP staff share the Provider's performance during face-to-face meetings with staff at the practice site.
- Quality Improvement Program Evaluation – Each year, NHP writes an annual plan to help us improve our clinical care, customer service, and patient safety. At the end of each year, NHP assesses outcomes of each initiative to see if we achieved our goals. The results also drive the development of the following year’s Quality Work Plan. See the results of our 2014 Quality Work Plan.
- Support Community Health Centers – NHP has a long history of working closely with the Community Health Centers (CHCs) to support their efforts to maintain and improve quality. There are several significant programs that we are currently supporting:
- Urgent Care Grants - NHP is administering $6.6 million in grants to Community Health Centers (CHCs) funded through CMS and EOHHS to reduce avoidable Emergency Room visits.
- Electronic Medical Records - EMRs are a significant way to improve quality through benefits such as identifying possible drug interactions and avoiding unnecessary repeat tests. NHP has provided funding to the Mass League of Community Health Centers (MLCHC) to support the migration to EMRs.
- Access and Redesign Collaborative - NHP is working with the MLCHC to help CHCs improve appointment availability and overall service to patients.