Quality Practice Advisory (QPA) Program
Nebraska Total Care is dedicated to delivering high-quality healthcare services for the Heritage Health programs. Nebraska Total Care has invested resources in an innovative quality improvement program. The Quality Practice Advisory (QPA) Program focuses on generating positive member health outcomes, improved population health, and collaborating with community healthcare providers to ensure our members are receiving the highest level of quality care.
What are Quality Practice Advisors?
The Nebraska Total Care Quality Practice Advisors (QPAs) have diverse backgrounds in driving quality patient care with expertise throughout the hospital setting. Our Associate Quality Practice Advisors act as a single point of contact for provider offices in support of member quality care, as well as to assist in the management of clinical requirements that are part of Healthcare Effectiveness Data and Information Set (HEDIS®), regulatory requirements, coding accuracy, performance and process improvement, and other priority quality measures.
What can QPAs do for you and your practice?
- Establish and foster a healthy working relationship between physician practices and the health plan.
- Educate providers and support provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment.
- Analyze and review quality outcomes to identify trends at the provider level
- Provide education for HEDIS measures, appropriate medical record documentation and appropriate coding.
- Assist in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards.
- Support the development and implementation of quality improvement interventions and audits in relation to plan providers.
- Collect, summarize trends, and deliver provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure.
- Collaborate with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).
If you would like to learn more about the Quality Practice Advisory Program and how the team can help support your efforts in providing high-class quality healthcare, please contact our Quality Improvement team.