SummaCare’s Quality Management Strategy

Program Description

SummaCare provides a high quality, low cost comprehensive, community-focused health plan that maximizes service with our integrated health system 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
  • Promoting preventive health and wellness through targeted interventions
  • Promptly identifying opportunities for improvement with actions for resolution

Member Mailings and Outreach

To remind and encourage members to get their preventive screenings SummaCare assists members by continuing to mail our annual preventive health and care opportunity letters. For members with chronic conditions such as diabetes and heart disease, care opportunity letters are also sent, which provide important information about screening and care for specific conditions. These letters help identify recommended services for you and your family. The care opportunity letter is only sent to members if we have not received claims by mid-year for the recommended cancer screenings, blood pressure checks and other tests or services. The letters are followed by a reminder phone call later in the year for members with continued care opportunities.

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

If you would like a summary of the annual program evaluation, call 330-996-8857.