Quality Performance Improvement

Quality Program

McLaren Health Plan (MHP) is committed to its mission statement, which describes the goal of the Quality Performance Improvement Program (QPIP), "To improve the health and well being of the people of Mid-Michigan through the promotion of illness prevention, the enhancement of their health status and providing access to quality health services."

The QPIP promotes the on-going assessment of MHP’s performance and directs interventions for continuous quality improvement. The QPIP goals are directed at the structure of the program with the core focus being to ensure appropriate utilization, assess performance and improve the health care of the MHP membership.

The core functions of the QPIP are:

  • Direct resource allocation
  • Evaluate performance
  • Assess barriers
  • Set performance goals
  • Identify opportunities for improvement
  • Implement interventions
  • Measure outcomes
  • Analysis of results
  • Direct the Quality and Utilization Work Plan

The scope of the QPIP is comprehensive, governed by MHP policy and focused on linking the five core elements: the key quality components, utilization management processes, the member’s rights and responsibilities, credentialing and recredentialing procedures and the health management programs. Individually, the integrity of these elements aid in the assessment of MHP’s ability to deliver quality health care and collectively they support the implementation of the appropriate interventions that will provide meaningful improvement. The scope of each element is presented in the body of the QPIP.

The Quality Improvement Committee (QIC) has responsibility for development, implementation and oversight of all quality and utilization activities. In response to the monitoring of utilization and the assessment of performance, the QIC identifies and prioritizes opportunities for improvement, sets performance goals and directs the quality interventions. The Quality and Utilization Work Plan provides a timeline and tracking means for the QIC. It includes the specific interventions, determines responsible parties, and monitors performance over time. All senior management staff, but specifically the Chief Medical Officer and the Vice President of Medical Management are responsible for developing the QPIP and the Quality Work Plan.

The key quality standards of the QPIP are vital in providing the program’s framework to enhance the health care delivery to the membership. These individual standards collectively demonstrate MHP’s commitment to the quality management process. Appropriate and specific MHP policies direct the process of each component when necessary.

The QPIP is reviewed at regular intervals during the year by senior management and the QIC. Successful implementation ensures MHP of meeting the program goals. An annual summary is available by clicking on the year to the left. If you are interested in joining the Quality Improvement Committee, or would like further information, please contact MHP at (810) 733-9711.