Quality Improvement

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Quality Improvement: Progress in Action

The Molina Healthcare Quality Improvement (QI) Program is a comprehensive framework for continuous assessment and focused improvement of all aspects of health care delivery and service. We annually assess the effectiveness of the QI Program so as to provide the structure and key processes that enable us to plan and implement our quality improvement goals. The QI Program is an evolving program that is responsive to the changing needs of our members and the advances and changes in clinical practice. The QI program focuses on critical activities for improving the services and facilitating the health care that is delivered by physicians and other health care professionals to our health plan members.

The goals and objectives of the Quality Improvement Program are to:

  • Measure and evaluate continuous performance according to, or in comparison with objective, measurable performance standards and benchmarks at the national, regional and/or at the local/health plan level;
  • Analyze information and data to identify needs;
  • Prioritize opportunities for improvement;
  • Design interventions for improvement;
  • Re-measure and re-evaluate processes; and
  • Evaluate the effectiveness of the quality improvement interventions and activities to identify and address additional opportunities for improvement.

The purpose of the Quality Improvement Program is to:

  • Provide a formal process to monitor and evaluate the quality, utilization, appropriateness, efficiency and effectiveness of the services and health care provided to our health plan members using a multi-faceted approach. This approach enables Molina Healthcare to focus on opportunities to improve health outcomes and satisfaction for our health plan members and our network providers.

The major focus areas of the Quality Improvement Program include, but are not limited to:

  • Clinical and Preventive Health Quality Improvement Activity implementation, analysis and Re-measurement
  • Member and provider satisfaction and feedback monitoring, tracking and identifying opportunities for improvement
  • Health promotion and education
  • Patient Safety
  • Health (e.g., Disease) Management
  • Pharmacy/Medication Management
  • Collaborative activities and delegation

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