Our Dedication to Quality

As a member, your health is our first priority. That’s why we have a Quality Assessment Performance Improvement (QAPI) program. The QAPI program looks for ways to make our services better. That can make it easier for you to stay healthy.

Our Medicare Enrollee Advisory Committee is one of the most important ways we hear from our members on topics, such as the following:

 
  • What are we doing well?
  • What could we do better?
  •  How might we add even more value to your plan’s benefits and services?

It gives members like you a chance to share feedback with us. It’s also a great opportunity to learn about the benefits and services available through your plan and connect with other plan members.
 

For each committee meeting you attend, we’ll reward you by adding a $25 reward on your &More Card.*

The committee meets for one hour every 3 months and takes place online, so you can join them from the comfort of home. You can use a phone, computer, or tablet.

Are you ready to join? Do you need more information or have questions? Please call Member Services at 1-833-433-3767 (TTY 711).

October 1 – March 31: 8 a.m. - 8 p.m., seven days a week and April 1 – September 30: 8 a.m. - 8 p.m., Monday through Friday.

 

Join our Medicare Enrollee Advisory Committee Meeting on the second Tuesday of the second month in the quarter at 10am. 
 

Meeting IDDateMeeting PasscodeMeeting Link
910 4537 4065Q3: August 11, 2026
Q4: November 10, 2026
388521Zoom Link

Or join by phone: 1-305-224-1968

*The &More Benefits Prepaid Mastercard® is issued by Avidia Bank, pursuant to a license from Mastercard, Incorporated. Use of this card is subject to the terms and conditions of the Cardholder Agreement. The &More Card cannot be used to purchase alcohol, tobacco, lottery tickets, or firearms.

 

QAPI program features

The QAPI program works to improve the quality of your health care. It gives us a structure and guidelines for medical clinical care, behavioral clinical care, and other member services.

The program also helps our members improve their health and wellness by:

  • Developing programs for members with special needs
  • Offering programs that help members manage their health
  • Arranging home visits and wellness events
  • Making health education available to members
  • Planning events to help you get care, find resources, and learn better ways to take care of you

Our goal is to make sure health care and services our members receive are:

  • High quality
  • Safe
  • Appropriate
  • Efficient
  • Effective

We review our QAPI program each year to see how we are doing. This review includes suggestions for improvement, as well as goals for the next year.

Our mission is to help people get care, stay well, and build healthy communities by creating programs to serve our members who have special health care needs.

Our goals for 2026

The plan will focus on reducing chronic conditions such as cardiovascular disease and diabetes, increasing preventive screenings and medication adherence, and improving health outcomes.

We will also prioritize improving the health of our members and reducing health care disparities by monitoring:

  • Access to care and services through assessing the availability and accessibility of providers.
  • Compliance with prescribed health screenings.
  • Develop member and provider outreach initiatives to improve utilization of services.
  • Develop chronic disease management through:
    • Effective care management programs.
    • Designing effective medication adherence programs.
    • Socialize evidence-based clinical practice guidelines to promote implementation of comprehensive medical and health care practices, including preventive, diagnostic and treatment services.
  • Promote coordination of care between medical and behavioral health providers, home health care agencies, and long-term care service providers by systematically improving care management communication with these providers
  • Address member safety through ongoing monitoring and investigation of root cause analyses and trends for potential quality of care and credentialing/recredentialing issues, as well as addressing issues identified through complaints and appeals.
  • Monitor Model of Care (MOC) metric performance toward established goals.
  • Empower members to work more collaboratively with their health care providers in implementing their care plans to maintain and/or improve their health.
  • Implement other Quality Initiatives to address ongoing support of process improvement, and the adoption of best practices within the managed care industry.

Call Member Services at 1-833-433-3767 (TTY 711), April 1 – September 30, 8 a.m. – 8 p.m., Monday through Friday; or October 1 – March 31, 8 a.m. – 8 p.m., seven days a week.

  • Would like to learn more about our QI program and its goals, activities, and outcomes.
  • Feel that you did not get quality care. Our QI team will look into the issue.

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