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Providers

Overview of Quality Improvement

San Francisco Health Plan is committed to continuous quality improvement of its health care delivery system.  The purpose of our Quality Improvement (QI) Program is to establish comprehensive methods for systematically monitoring, evaluating and improving the quality of the care and services provided to San Francisco Health Plan members.

Under the leadership of the SFHP Governing Board, the Quality Improvement Program is developed and implemented through a QI committee structure.  The QI committee structure, with the central involvement of the SFHP Medical Director, assures ongoing and systematic interaction between the health plan and its key stakeholders: members, medical groups and practitioners.

The goal of the SFHP Quality Improvement Program is to assure that San Francisco Heath Plan provides high-quality care and services to members by aggressively seeking opportunities to improve the performance of our health care delivery system. SFHP identifies quality improvement activities that allow it to monitor, evaluate and improve performance.
 
San Francisco Health Plan relies on its medical groups and providers to cooperate in meeting the objectives of it Quality Improvement Program.  Each year the Plan determines its specific goals for the year and develops relevant quality improvement activities.  These activities often require the participation and support of the medical group.

Areas of emphasis include:

  • Improving the health status of the heath plan population membership
  • Providing continuity and coordination of care 
  • Providing access and availability of care and service
  • Assuring members rights and responsibilities
  • Assuring member satisfaction
  • Assuring that health care practitioners are appropriately credentialed and recredentialed and all organizational providers meet accreditation standards
  • Assuring timely communication of standards and requirements to participating medical groups and organizational providers
  • Assuring effective and appropriate utilization management of health care services, including medical, pharmaceutical and behavioral health care services
  • Assuring that responsibilities delegated to medical groups meet Plan standards, etc.

If you have any questions about our Quality Improvement Program, please email Dori Lange, Director of Quality Improvement, or call (415) 615-4211.