Quality Improvement Program: Members
True Commitment to You
True Health New Mexico is committed to providing a high degree of quality care and services for our members. As a result, the Quality Improvement Program (QIP) is designed to systematically monitor, evaluate, and improve all areas of the health plan.
To improve members’ health status, optimize health outcomes, and ensure a high degree of quality care and services are delivered.
All True Health New Mexico members achieve the quality of life they want to have.
Quality Improvement Program Priorities
- Maintaining national and state quality standards
- Clinical quality measurement and improvement
- Population health management
- Member engagement and satisfaction
Participating in the Quality Improvement Program
True Health New Mexico invites all members to participate in the QIP by obtaining all recommended screenings. You can learn more about preventive screenings on our Preventive Health Screenings page. We also publish preventive health screening reminders in our member newsletter, which we mail four times per year.
Your health and wellness are very important to us, and we do regular outreach to ensure you are receiving the healthcare services you need. Some of this outreach may include:
- A phone call from a pharmacist about our medication therapy management program.
- A phone call and letter offering an in-home or telehealth visit to assess your overall health.
- A phone call and letter offering members with diabetes an in-home diabetic eye exam.
- A phone call or letter from our provider partners to remind you of recommended preventive health screenings.
While this outreach doesn’t replace a doctor’s care, it can help fill some gaps.
These services are available at no cost to you, and they will not affect your True Health New Mexico benefits, cost-sharing amounts, or premiums.
You are never obligated to take part in any of these services. If you would like to opt out, just tell the caller, and we will put you on a do-not-call list.
What We Do
The True Health New Mexico QIP is an important part of your health plan. True Health New Mexico is committed to the development, implementation, administration, and monitoring of initiatives designed to promote a healthier population.
True Health New Mexico collects and evaluates data on Healthcare Effectiveness Data and Information Set (HEDIS®) measures. This set of measures helps us understand how we are doing year over year and helps us design improvement projects to improve the health of our members.
You Have the Right to See Our Quality Assurance Plan
If you would like to see our Quality Assurance Plan, you may request it via email at firstname.lastname@example.org.
We partner with a National Committee for Quality Assurance (NCQA) certified vendor to evaluate how satisfied our members are with their health plan and our provider network. We also focus on member satisfaction by inviting members to take our Net Promoter Score surveys.
We have multidisciplinary staff that helps our members manage their chronic conditions, coordinate their care, and follow up after hospitalizations. We set care management measures and evaluate them every year to ensure we are providing the best care management in New Mexico.
We partner with CVS to make sure our members are receiving the right dose of their medications, are adhering to those medications, and are educated on how to take medications properly.
Health and Wellness
We partner with community health workers and first responders to help our members learn how to care for themselves after a major healthcare event, such as a surgery or diagnosis.