'Ohana Health Plan’s Quality Improvement (QI) Program monitors and evaluates the quality, appropriateness, accessibility and availability of health care services.
QI may conduct annual medical record audits in physician offices. Patient records are reviewed for evidence that care and screenings have been documented. Complete information is available in the Medicaid or Medicare Advantage provider manuals.
CPGs outline medical standards of care and best practices.
HEDIS® is a mandatory process that occurs annually. We've developed this toolkit to help identify required preventive services.
Sign in to our secure Provider Portal to find out which eligible members are due for EPSDT screenings. If you haven't registered on our site, please join today. Preventive pediatric health care guidelines for children are located in our clinical practice guidelines.
Network providers are contractually required to cooperate with quality improvement activities. Providers are also invited to volunteer for the QI Program. Please contact us if you're interested in volunteering.