Quality Management

TRICARE and CSMV Logo

We are dedicated to helping TRICARE Prime Demo beneficiaries get safe, high-quality care. Our Quality Management program helps us find ways to improve your care and your health care experience.

What is Quality Management?

Quality Management means we review health care services and beneficiary feedback. This helps us make sure care is safe, works well, happens on time and meets your needs. We also work with health care providers to support best practices and better health outcomes.

Our Commitment to You

We want you to get care that is respectful, fair and focused on you. We work to improve quality, safety and satisfaction so we can better support your health and well-being.

Learn More About Quality Management

Review the sections below to learn how our Quality Management program works and how it helps improve your care.

Clinical Quality Management Program (CQMP)

The CQMP is our plan to improve your health care experience. We follow trusted health guidelines. We also check the care you receive to help make sure it is safe, timely and meets your needs.

What CQMP Does For You

  • Help you see skilled, competent practitioners in a timely manner.
  • Keep you safe by helping prevent mistakes before they happen.
  • Support your understanding and satisfaction with your care.
  • Help you stay healthy and manage any health concerns.
  • Treat everyone fairly, regardless of who you are or where you live.

Ways To Take Part In Your Care

You play an important role in your health. Here are ways you can take part in your care:

  • Share your feedback by taking CSMV surveys. Your input helps us improve your experience.
  • Keep track of your medicines, allergies and health history, and share this information with your health care providers.
  • Ask questions and take part in decisions about your health care with your care team.
  • Review the health information we send you. It can help you understand your conditions and care options.

Quality Measures, Surveys and Improvement Result

We use trusted tools to check and improve the care you receive from us.

Key Quality Measures We Use

  • Healthcare Effectiveness Data and Information Set® (HEDIS®): A national tool that checks whether health plans meet care standards.
  • Consumer Assessment of Healthcare Providers and Systems® (CAHPS®): A survey that asks about your care experience.
  • Provider Satisfaction Surveys: A survey that asks health care providers about their experience working with us.
  • Utilization Patterns: These show how health services are used so we can help prevent too much or too little care.

Our Quality Management Goals

We set goals and review them often to:

  • Help you stay healthier through preventive care.
  • Improve the quality and ease of your care experience.
  • Lower the cost of care while keeping high standards.
  • Work toward better health outcomes for all beneficiaries.

How We Use This Information

Your feedback and health care data help us:

  • Find areas we need to improve.
  • Create programs that improve care quality.
  • Track progress to make sure we meet our improvement goals each year.

This supports the goals of our CQMP to improve your care.

Have questions? Want to learn more or share feedback? Call Beneficiary Services at 1-833-230-2080 (TTY: 711). We’re here for you.