SummaCare’s Quality Management Strategy

Program Description

SummaCare provides a comprehensive, community-focused health plan that maximizes service and choice to our providers, members and employers. We are committed to a thorough and effective Quality Management Program that follows the principles of Continuous Quality Improvement to improve the care and services members receive. 

Major goals and objectives of the program include:

  • Promoting and building quality into the structure and processes of our organization
  • Monitoring and working to improve outcomes
  • Enhancing the customer experience and promoting preventive health and wellness through targeted interventions
  • Promptly identifying opportunities for improvement with actions for resolution

Member Mailings and Outreach

To assist members in obtaining preventive screenings and optimal care for chronic conditions such as diabetes and cardiovascular diseases, SummaCare continues to send annual preventive health letters that identify recommended services for our members.

Various care opportunity letters are sent throughout the year to members if we have not received claims by mid-year for recommended screenings and other health related conditions. These letters are intended to remind and encourage our members to contact their physicians to obtain the care they need.

We continue to evaluate and improve our outreach to members and providers to determine additional effective ways to help members get the care they need.

For more information on our Quality Management Program, visit the member section on the website. If you would like a summary of the annual program evaluation, call 330-996-8857.