QI Program

We are committed to the provision of a well-designed and well-implemented Quality Improvement (QI) program. Our culture, systems and processes are structured around this mission to improve the health of all enrolled members.

Scope
The scope of the QI Program is comprehensive and addresses both the quality and safety of clinical care and quality of services provided to Peach State Health Plan's members including medical, behavioral health, dental and vision care. We incorporate all demographic groups, care settings, and services in QI activities, including preventive care, emergency care, primary care, specialty care, acute care, short-term care, long-term care (depending upon Peach State Health Plan's products), and ancillary services.

Goals & Objectives
Our primary quality improvement goal is to improve members’ health status through a variety of meaningful quality improvement activities implemented across all care settings and aimed at improving quality of care and services delivered.

Credentialing Standards

For consideration to participate in the Peach State Health Plan network, all licensed physicians and other licensed healthcare professionals who have an independent relationship with Peach State Health Plan must complete an application for participation and submit copies of applicable supporting documentation.

Cultural Competency Plan
Cultural competency within the Peach State Health Plan Network is defined as “A set of interpersonal skills that allow individuals to increase their understanding, appreciation, acceptance, and respect for cultural differences and similarities within, among and between groups and the sensitivity to know how these differences influence relationships with members”.

Peach State Health Plan is committed to the development, strengthening and sustaining of healthy provider/member relationships. Members are entitled to dignified, appropriate and quality care. When healthcare services are delivered without regard for cultural differences, members are at risk for sub-optimal care. Members may be unable or unwilling to communicate their healthcare needs in an insensitive environment, reducing effectiveness of the entire healthcare process.

Peach State Health Plan as part of its credentialing and site visit process will evaluate the cultural competency level of its network providers and provide access to training and tool kits to assist provider’s in developing culturally competent and culturally proficient practices.

Quality Assessment Performance Improvement Program

Cultural Competency Resources

Resource Materials
Peach State Health Plan members receive printed information through mailings and during face-to-face contact. Peach State produces all vital materials in English and Spanish, and as requested, in additional languages and formats (e.g., Braille, large font and audio tapes).

Support Resources

Healthcare Quality and Disparities Data

E-Learning Program: For additional information on developing and meeting cultural competency standards within your practice, please review A Physician’s Practical Guide to Culturally Competent Care at: https://cccm.thinkculturalhealth.hhs.gov/The program has been updated to include the new National CLAS Standards, more interactivity, and updated literature and references!

Participation in QI
Peach State Health Plan requires providers and practitioners to cooperate with all Quality Improvement activities, as well as allow the use of provider and/or practitioner performance data, to ensure the success of the QI Program. The Peach State Health Plan QI Program is outlined on the Peach State Health Plan website www.pshpgeorgia.com and is available upon request. If you are interested in learning more about Peach State Health Plan's QI Program, please contact Peach State Health Plan at 1-800-704-1484 and ask to speak with the Quality Improvement Department.