Quality and Accreditation Information

Health Services for Children with Special Needs, Inc. (HSCSN) mission is to improve the health status and quality of life for children, youth and young adults with special needs, their families and communities. To support this mission, HSCSN maintains an active Quality and Performance Improvement Program and continually assesses this program to:

• Improve the quality of healthcare services for enrollees and their access to those services
• Communicate clinical information to enrollees and providers
• Monitor and evaluate the quality and safety of healthcare provided to enrollees
• Achieve and maintain NCQA Organization Certification
• Met or Exceed External Quality Review Organization requirements

Quality and Performance Improvement Program Publications

• Quality and Performance Improvement Program Description
• Quality and Performance Improvement Program Evaluation

Quality and Performance Improvement Program Activities

Specific quality and performance improvement activities include:

Enrollee

• Satisfaction Measurement
  • HEDIS CAHPS Satisfaction Survey
• Access & Availability Measurement
  • Access & Availability Survey
• Analysis of Complaints & Grievances
• Identifying Potential Quality of Care Issues
• Safety Monitoring & Activities
  
  • Mortality Reviews
  • Provider/Practitioner Office Reviews
  • Facility Adverse Occurrence Monitoring

Provider/Practitioner

• Satisfaction Measurement
  • Provider Satisfaction Survey
• Clinical Practice Guidelines
• Secret Shopper Survey
  • Secret Shopper Survey Results
• Medical Record Documentation Monitoring
• HEDIS Performance Measures
• QI Collaborative Performance Improvement Projects
  • Adverse Perinatal Outcomes
• Chronic Condition Outcomes

Organization

• National Committee for Quality Assurance (NCQA) Organization Certification (Credentialing & Utilization Management)
• External Quality Review Organization Reports
  • Operational Standards Results (CY 2010)
  • Performance Improvement Projects (CY 2009)