Better health care Setting the bar for a higher quality of health care is important to us. And with each patient, we have the opportunity to improve The Sharp Experience by delivering high-quality care and service. Learn about the progress we’re
making, our current goals, and how we’re tracking our efforts.
Seeing results alreadyAccording to the clinical measurement results from the Healthcare Effectiveness Data and Information Set, we’ve already made great progress. Our effectiveness for Medication Management for People with Asthma; Cervical
Cancer Screening and Statin Therapy for Patients with Cardiovascular Diseases Adherence have already increased. And we won’t stop there. We’re committed to exceeding expectations for all clinical measures so that Sharp Health Plan members
can get the best possible care available.
We believe that by defining our goals in a clear and concise way, we can make major efforts in our quest to improve health care. Take a look at the ones we are most focused on achieving right now:
- Deliver quality care and services that set community standards
- Fulfill and exceed members’ expectations of care
- Give members care that is compassionate and effective
- Make it easier to get care while staying within the financial means of members
Efforts and programs
To help us reach our goals, we’ve started a few practices and programs that we believe can impact the quality of health care in a positive and effective way.
One of our specific goals is to create a more collaborative and secure health care environment. And to do this, we have begun to closely monitor clinical performance indicators, validate provider credentials, and track the coordination of care to ensure
a safe delivery system. Through patient safety we can reduce medical errors, which will result in higher standards of care.
Emphasizing preventive health
Part of improving the quality of care begins with members becoming familiar with preventive health guidelines. That’s why we’ve created checklists for women, men, adolescents, and children to help them plan effective care and treatment with
their doctors. Besides these preventive care checklists, you will find ones for diabetes and hypertension.
Making it easy on providers and members
Another effort of ours is to make sure our provider network is large enough for members to get health care services in a more convenient and easier way. To check and see if we are fulfilling our duties, we send out a yearly survey to providers in our network.
Based on their answers and feedback, we can take steps to ensure a better experience for both doctors and members.
Programs for managing health concerns
It’s important that our members have resources to help them understand how they can better manage their health. We’ve started programs for Disease Management and Case Management so that members can have helpful educational resources or talk
to someone about their or a loved one’s condition. To learn more about these programs, email firstname.lastname@example.org, fill out a referral form on Sharp Connect, or call
Customer Care at 1-800-359-2002
Quality Improvement Program Activities
Patient SafetySharp Health Plan advocates a collaborative approach to foster a culture of patient safety, reduce medical errors, and promote high quality care. Sharp Health Plan focuses on monitoring clinical performance indicators, provider credentialing and coordination of care to ensure a safe delivery system.
Preventive Health and Clinical Practice Guidelines
Preventive health guidelines are reviewed and updated using the most current and reasonable published medical evidence and the U.S. Preventive Services Task Force recommendations. Clinical practice
guidelines encompass acute and chronic care relevant to Sharp Health Plan’s membership. Preventive and clinical practice guidelines are available to practitioners in the Sharp Health Plan
Provider Operations Manual. The guidelines and the Preventive
Health Services Medical Benefit Policy for all ages can be found on the clinical resources page
Access and AvailabilitySharp Health Plan monitors health care provider compliance with California laws regarding timely access to care. Sharp Health Plan is responsible for ensuring that the provider network is sufficient to ensure accessibility, availability and continuity of covered health care services. Sharp Health Plan is also responsible for ensuring members receive covered
services in a timely manner. The Industry Collaborative Effort (ICE) Provider Satisfaction with Access Survey is completed annually for doctors in contracted medical groups. The Provider Access Appointment Availability Survey is also completed
Health Management ProgramsSharp Health Plan monitors health care provider compliance with California laws regarding timely access to care. Sharp Health Plan is responsible for ensuring that the provider network is sufficient to ensure accessibility, availability and continuity of covered health care services. Sharp Health Plan is also responsible for ensuring members receive covered services in a timely manner. The Industry Collaborative Effort (ICE) Provider Satisfaction with Access Survey is completed annually for doctors in contracted medical groups. The Provider Access Appointment Availability Survey is also completed each year. Health Management Programs Sharp Health Plan’s Disease Management and Case Management programs are available to meet the health care needs of members with complex health conditions or diseases through communication, education and resources. If you would like more information about our Disease Management and Case Management Programs, please contact Customer Care at
1-858-499-8300, 1-800-359-2002 or email@example.com
What is Healthcare Effectiveness Data and Information Set (HEDIS®)?
HEDIS is a commonly-used set of health care performance measures in the U.S. It measures 75 aspects of care in the following categories:
- Effectiveness of care
- Access/availability of care
- Use of services
- Cost of care
With the measurement results from HEDIS, the health care field can find areas that need improvement and take steps for making the quality of care better for members and staff.
What is Consumer Assessment of Healthcare Providers and Systems (CAHPS®)?Another way we assess the health care experience is through the CAHPS survey. Every year the survey is sent to our members so that they can review us and their doctors as
well as rate the quality of care they've received. Based on these results, we can find out what we need to fix and work with our doctors to improve the patient experience.