Quality Improvement 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 Iowa Total Care’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), and ancillary services.

Goals & Objectives

Our primary QI goal is to improve members’ health status through a variety of meaningful QI activities. Such activities are implemented across all care settings and are aimed at improving the quality of care and services delivered.

Credentialing Standards

To participate in the Iowa Total Care network, all licensed physicians and other licensed healthcare professionals who have an independent relationship with Iowa Total Care must complete an application for participation and submit copies of applicable supporting documentation.

Cultural Competency Plan

Iowa Total Care is committed to establishing multicultural principles and practices throughout its organizational systems of services and programs. That mission is supported by facilitating the process by which Iowa Total Care can respond to the health care needs of all individuals, regardless of their ethnicity, cultural practices, religious beliefs or language. Our Cultural Competency plan is reviewed and updated annually.

Participation in QI

Iowa Total Care requires providers and practitioners to cooperate with all QI activities, as well as allow the use of provider and/or practitioner performance data, to ensure the success of the QI Program. The Iowa Total Care QI Program is outlined on the website and is available upon request. If you are interested in learning more about Iowa Total Care’s QI Program, please contact Iowa Total Care at quality@iowatotalcare.com or 844-738-5019 to speak with the Quality Improvement Department.

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

Iowa Total Care is dedicated to partnering with providers to help maximize opportunities to improve patient care and the member’s experience with their health plan and their providers. We use a tool titled CAHPS^® to gauge member experience. Other rating systems will also be available on the member portal and will be shared with our Provider partners periodically or on demand.

Please also reference the provider manual for additional details about the program.