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Quality Improvement Program

Quality Improvement Program

Community Health Choice cares about all our Members. Our vision is a healthy life for every Texan. Our mission is to improve the health and well-being of underserved Texans by opening doors to health care and health-related social services.

Quality Improvement Program

The quality of our care and services is very important to Community, as is our Members’ safety. Our Quality Improvement Program uses things like quality scores, reports, and Member and Provider satisfaction surveys to see how we are doing.

The program’s overall objectives are to help us monitor and evaluate real-life opinions about our services and processes, and then use the results to make improvements in areas such as:

  • Healthcare access and delivery
  • Customer service and satisfaction
  • Provider service and satisfaction
  • Care (disease) management and complex case management
  • Preventive and interventional healthcare services

Consumer Assessment of Healthcare Providers and Systems (CAHPS®)

The CAHPS® survey asks about the health care you and your family are receiving from Community Health Choice to help us understand:

  • How satisfied you are with Community
  • How satisfied you are with your primary care physician and specialist
  • How fast and easy you can get care
  • How well you and your doctor talk about your care
  • How satisfied you are with your care and services
  • How Community can improve

Healthcare Effectiveness Data and Information Set (HEDIS®)

Community Health Choice uses HEDIS® each year as a way to measure the quality of our care and services. These HEDIS® measures also show where plans can improve. Community’s strategic goal is to be better than 75 percent of other Medicaid health plans in the nation.

Community Health Choice Programs for Qualified Members

Community offers many programs to make our care and services even better. These include:

  • Case Management: assigns Case Managers to Members who help them learn to manage their health, follow their doctor’s plans of care, and get the care they need.
  • Disease Management: provides education and support to Members with certain chronic conditions.
  • Medication Therapy Management: connects Members to a pharmacist who helps them manage their medicines.
  • Utilization Management: helps control costs and ensure the medical need for medicines, surgeries, and hospital stays.
  • Nurse Line: a free telephone service allowing Members to talk to a nurse about health concerns 24 hours a day, seven days a week

H9826_IT_10045_092919_M Last updated October 27, 2020.

Why Choose Community?

As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.

“Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”

– Cecily
Member of Community Health Choice