Quality Management
Delivering safe, effective and high-quality care starts with a strong provider network. Our Clinical Quality Management Program (CQMP) helps us review care, track quality and improve health outcomes for beneficiaries.
Your expertise and partnership help us improve health outcomes and support a better care experience for beneficiaries.
What Is The CQMP?
The CQMP follows evidence-based clinical guidelines, supports regulatory compliance and helps promote patient-centered care across the network.
Our Overarching Goals
- Provide timely, evidence-based care following Defense Health Agency (DHA) and Department of Defense (DoD) standards.
- Enhance beneficiary safety by reducing medical errors.
- Support provider performance through data-driven feedback and peer review.
- Ensure network adequacy for timely access to qualified providers.
- Promote health equity and improve clinical outcomes and patient experience.
Why It Matters To You:
Through the CQMP, we offer many tools and resources that support your practice and beneficiary care.
Data & Analytics: Interactive dashboards show your HEDIS® performance and highlight open care gaps.
Clinical Practice Tools: Instant access to evidence-based guidelines and clinical policy updates aligned with national standards.
Collaboration & Feedback: Join peer reviews and advisory committees that shape quality initiatives and clinical policies.
Education & Support: Tailored educational resources and timely insights help you stay compliant and support high quality care.
How You Can Participate
- Review your performance reports in the Provider Portal and address care gaps.
- Join provider advisory and peer review activities. Contact the Medical Director to discuss how to get involved.
- Use recommended Preventive and Clinical Guidelines.
- Keep up-to-date on polices and quality initiatives.
For questions or more information, please call Provider Services at 1-833-230-2170.