Quality Improvement Program

California Health & Wellness' Quality Improvement (QI) Program focuses on preventive health. The program creates plans, puts those plans into action, and measures efforts to improve your health and safety. 

The QI Program strives to make a difference in health outcomes. It develops actions to improve member and provider satisfaction. California Health & Wellness involves providers within our plan. The providers assist with developing and monitoring activities of the QI Program as well as providing insight into preventive health resources and information.

For questions about the QI Program and our progress on meeting goals, call the Member Services department at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).

The QI Program also reviews services provided to our members. We have clinical practice guidelines for certain conditions. If you would like a copy of these guidelines or need more information about programs call us at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).

Information and/or a full copy of California Health & Wellness' current QI Program Description is available upon request.

We are committed to the provision of a well-designed and well-implemented Quality Improvement Program (QI Program). Our culture, systems and processes are structured around its mission to improve the health of all enrolled members.

Scope

The scope of the QI Program is comprehensive and addresses both the quality and safety of clinical care and quality of services provided to California Health & Wellness' members. We incorporate all demographic groups, care settings, and services in its QI activities, including preventive care, emergency care, primary care, specialty care, acute care, short-term care, long-term care (depending upon California Health & Wellness’s products), and ancillary services.

Goals & Objectives

Our primary quality improvement goal is to improve members' health status through a variety of meaningful quality improvement activities implemented across all care settings and aimed at improving quality of care and services delivered.

Credentialing Standards

For consideration to participate in the California Health & Wellness network, all licensed physicians and other licensed healthcare professionals who have an independent relationship with California Health & Wellness must complete an application for participation and submit copies of applicable supporting documentation.

Cultural Competency Plan

California Health & Wellness is committed to establishing multicultural principles and practices throughout its organizational systems of services and programs. That mission is supported by facilitating the process by which California Health & Wellness can respond to the healthcare needs of all individuals, regardless of their ethnic, cultural, religious beliefs or language.