Quality Program for Members

True Health New Mexico is dedicated to partnering with a network of providers to bring the best quality of care and service to our members. We developed our Quality Program to help ensure that we meet this goal. The program is designed to provide a broad view of quality and to touch on and continually improve the following key components of healthcare. They are:

  • Making care safer by reducing harm.
  • Engaging patients and family as partners in their care.
  • Promoting effective communication and care coordination.
  • Promoting the most effective prevention and treatment practices.
  • Working with communities to enable healthy living.
  • Making care more affordable through new healthcare delivery models.

The tools we’ve created for our Quality Program include a program description and an annual work plan. We update them continually, as needed. We are always reviewing our work to see how well we meet our program goals.

National Committee for Quality Assurance (NCQA) Accreditation

We currently hold Interim Accreditation from the National Committee for Quality Assurance (NCQA) and follow its guidelines and standards as set forth each year. These guidelines cover credentialing, utilization management, case and disease management, wellness promotion, member communication, access and availability, member complaints, and members and provider satisfaction. to name a few.

We have formed a Quality Committee that oversees all our quality activities. This committee ensures True Health New Mexico has established measurement systems to continually assess our performance. 

True Health New Mexico takes part in several national quality-comparison projects each year. The first, called Healthcare Effectiveness and Data Information Set (HEDIS®), measures our provider network’s clinical performance and whether you, our members, are getting preventive screening, tests, and immunizations on time. The other comparison projects relate to member’s experience with customer service, health plan operations, and access to care.