Quality at FCHP

NCQA "Excellent" accreditation

Fallon Community Health Plan aims to assure that safe, effective, patient-centered, timely, efficient and equitable clinical care and services are provided to members. To ensure the quality and safety of clinical care and service, FCHP has established Quality Programs. In order to continually improve services to members in the community, Quality Programs aligns with Fallon Community Health Plan’s mission, values and vision statements.

For detailed Quality Programs information:
Download FCHP’s Quality Programs brochure

FCHP is one of the highest-rated health plans in the nation

NCQA badges 2012 - 2013Fallon Community Health Plan is the #1 Medicaid health plan in the country according to the National Committee for Quality Assurance’s Medicaid Health Insurance Plan Rankings, 2012-2013. This is the fifth time in the past six years that FCHP has achieved this distinction. 

FCHP's Medicare HMO was ranked 8th out of 395 plans, making it the highest ranked health plan in Massachusetts. 

FCHP's commercial HMO was ranked 33th out of 474 plans.

Learn more about FCHP's rankings

 

National accreditation and Quality Plus distinction

FCHP maintains "Excellent" accreditation status for our commercial, Medicaid and Medicare Advantage products from the National Committee for Quality Assurance (NCQA,) an independent, not-for-profit organization dedicated to measuring the quality of America’s health care. "Excellent" accreditation is the NCQA's highest possible status and is reserved for the best health plans in the nation. FCHP is the only Massachusetts health plan to be accredited across all three product lines.

FCHP has also achieved Quality Plus Distinction for Physician and Hospital Quality from the National Committee for Quality Assurance—an independent, not-for-profit organization dedicated to measuring the quality of America’s health care. NCQA-accredited health plans can opt to achieve distinction in “Quality Plus” content areas in addition to their accreditation.

For details:
National accreditation and Quality Plus distinction
Download FCHP’s Quality Programs brochure 
Visit NCQA's Web site

HEDIS® is sponsored by NCQA. HEDIS® is a registered trademark of the National Committee for Quality Assurance.

Patient safety standards

Fallon Community Health Plan collaborates with providers, hospitals and regional and national coalitions to improve health care delivery and minimize medical errors.

Activities associated with patient safety include the clinical peer review activities that identify case reviews related to clinical quality and the evaluation of possible errors of commission and omission. Corrective action plans are also carried out when areas of substandard care are identified, and follow-up is required that addresses practitioner-specific components as well as system issues identified through peer review committees.

Pharmaceutical patient safety is also monitored, with procedures in place for point-of-dispensing communications to identify drug-drug interactions and classify them by severity. Screening of new drugs and technologies occurs through FCHP’s Pharmacy and Therapeutics Committee and Technology Assessment Committee, with input from national guidelines and research consortia.

For details on patient safety standards: 
Download FCHP’s Quality Programs brochure

Hospital patient safety standards

Fallon Community Health Plan voluntarily participates in the activities of The Leapfrog Group, an initiative driven by organizations who are working to initiate breakthrough improvements in the safety, quality, and affordability of healthcare for Americans.

The Leapfrog Group has developed standards in several key areas:

  • Physician staffing in intensive care units
  • The use of computers in hospitals for ordering prescriptions
  • The number of certain high-risk treatments or procedures a hospital performs each year
  • A Leapfrog Quality Index summarizing performance on the 27 National Quality Forum procedures to reduce preventable medical mistakes.

For details on hospital patient safety standards: 
Download FCHP’s Quality Programs brochure
Visit Leapfrog's hospital standards at www.leapfroggroup.org

* NCQA is a private, non-profit organization dedicated to improving health care quality.