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NOTICE OF DATA BREACH

We are sorry to tell you about a privacy event that impacted our vendor, Episource, LLC (“Episource” or “They”). Episource works with health plans, including Peach State Health Plan. This event may have involved your data. Click here to learn more about the data breach.
 

Quality Improvement Program

Peach State Health Plan’s Quality Assessment and Performance Improvement (QAPI) Program is an important part of the Health Plan. Quality is merged throughout the health plan and represents the strong commitment to the quality of care and services for members.  The program creates plans, carries out actions and review results to improve health outcomes as well as increase member and provider satisfaction.  The QI program monitors the quality of care and services provided by reviewing the following:

  • Cultural Needs of our Members
  • Member satisfaction
  • Health Plan services members are using
  • Involving Doctors in our planning

These activities are in line with our goals and objectives to:

  • Improve the health and health care provided to each member as individuals
  • Improve the health of all members enrolled in the plan
  • Lower costs

Peach State Health Plan is always looking for ways to make things better for our members. We carefully review our processes and activities to improve the experience for everyone.

Here are our 2024 survey results for member satisfaction:

  • Medicaid Child CAHPS: 72% of members were satisfied with Peach State Health Plan.
  • Medicaid Adult CAHPS: 67% of members were satisfied with Peach State Health Plan.

What We Did in 2024 to Improve Our Services:

  • Helped members request a release of information form so their doctors can share important health details.
  • Worked with provider offices to schedule member appointments.
  • Launched the ShareCare app to help members stay on top of their health and learn about extra benefits. 
  • Reached out to members after they completed surveys to make sure their needs were met.
  • Shared tips in newsletters to help doctors and staff avoid burnout.

For questions or more details about our QAPI Program and progress toward our goals, call a customer service representative at 1-800-704-1484.

You can also request a copy of Peach State Health Plan’s Health Equity & Diversity Program Documents or the Quality Assessment Performance Improvement Program Description.

Each year, we ask for your feedback. You can also share your thoughts anytime by calling or sending us a letter.

Mailing Address:

Peach State Health Plan
Attention: Quality Improvement
1100 Circle 75 Parkway, Suite 1100
Atlanta, GA 30339

You deserve the best care management. Our providers are committed to helping you manage your care. Members most satisfied with the coordination of their care do the following activities: 

  • Ask your provider about gaining access to the practice patient portal to receive lab / test results as soon as they are available
  • Contact your doctor or insurance provider to ask any questions about the care plan or if you have concerns about treatment options.
  • If you have a referral and need help scheduling an appointment for follow-up care, call your referring provider or your insurance provider to assist with scheduling.
  • Sign a release form with your PCP and with each of your specialists, if you have any, to allow them to share your medical record information with each other. Knowing about all the care you receive is important for your providers to give you the best care necessary.

Do you want even more help managing your care? We are here to help you.

  • Medicare: Contact your Agent and / or Customer Service to receive a referral to Care Coordination or ask questions about the forms you receive from the Plan.
  • Ambetter: Contact Member Services at 1-877-687-1180 to receive a referral to Care Coordination or ask questions about the forms you receive from the Plan.
  • Medicaid: Contact 1-800-704-1484 for Care Coordination assistance.