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Your health is important to us. We want our members to receive the best care. We have a Quality Improvement Health Equity (QIHE) Program to help us meet this goal and to fix any problems that we find. Each year we set higher goals to improve the service we provide. 

QIHE PROGRAM GOALS 

  • Help doctors and health care facilities improve quality of care 
  • Help members get the best care  
  • Increase member and doctor satisfaction  
  • Measure and improve the quality of our service  
  • Ensure that care is equitable for all 

 

 

HOW DO WE IMPROVE THE CARE AND SERVICES YOU RECEIVE?

We use information from data and surveys to understand whether members are getting the care they need and to learn how we can improve your overall experience. 

One of the main ways we do this is way we do this is through a set of scores called HEDIS® (Healthcare Effectiveness Data and Information Set) and StarTAR ratings. These scores show tell us how well we are doing on important health services, such as when it comes to members getting care they need, like prenatal care if you are pregnant colorectal cancer screening, mammograms, and lab and eye tests if you have diabetes. The final STAR ratings will be available in 2027.  

  • Preventative care screenings   
  • Managing chronic conditions (Diabetes)  
  • Follow-ups after hospital stays   

IF YOU RECEIVE A HOS AND/OR CAHPS® SURVEY, PLEASE COMPLETE IT AND RETURN. Your voice makes a difference.  

We visit our doctors and health care providers’ offices and facilities to see how we can help them improve. 

TIMELY ACCESS TO CARE

As an Alameda Alliance Wellness member, you have the right to timely access to care. 

We also monitor our member’s ability to get care when needed by conducting different surveys, such as the Provider Appointment Availability Survey (PAAS). PAAS reviews how quickly you can get a routine and urgent appointment. 

To view and download the Timely Access to Care chart, please select your preferred language: 

Coming soon: English | Spanish | Chinese | Vietnamese | Tagalog | Farsi 

 

APPOINTMENTS WAIT TIME (D-SNP) 
Appointment Type:  Appointment Within: 
Urgently needed services or emergency that does not require Prior Authorization  Immediately 
Non-urgent primary care appointment   7 Business Days of Request 
Routine or preventive care  30 Business Days of Request 

 

Other things we review include what services and medicines members receive, samples of medical records, member’s complaints and appeals, and any other issues of concern that we may find. 

We make a yearly work plan to improve our service and care. This work plan includes the work we will do, who will do the work, and when the work will be done.  

We evaluate our work plan every year to determine how we did.  

As a part of our work plan, we may: 

  • Offer members disease management and health programs. 
  • Remind members to get screenings, lab tests, and vaccines. 
  • Measure the quality of care and service from our doctors and health care providers. 
  • Promote increased safety in health care through member and provider education. 
  • Work with all Alliance staff and providers in our network to improve the service you receive. 

RESOURCES

If you would like to share your ideas for our QIHE Program or request a paper copy of the QIHE Program or QIHE Work Plan, please refer to Quality Improvement Health Equity (QIHE) – Alameda Alliance for Health or call: 

Alameda Alliance Wellness Member Services Department
Seven (7) days a week, 8 am – 8 pm, including holidays
Toll-Free: 1.888.88A.DSNP (1.888.882.3767)
People with hearing and speaking impairments (CRS/TTY): 711/1.800.735.2929