Blue Cross and Blue Shield of Texas (BCBSTX) has a Quality Improvement Program to better serve our members.
The purpose of the Quality Improvement Program is to provide a way to monitor and improve the care and service our members receive.
Through the Quality Improvement Program, BCBSTX measures performance and progress against the goals we’ve set. The program focuses on preventive care, behavioral health, patient safety and condition management.
By working with physicians and other health care professionals and providers, the program helps promote safe and appropriate care while encouraging the efficient use of resources.
This helps reduce health care costs and improves members’ satisfaction with their health plans.
We regularly evaluate care and service to determine whether members are receiving appropriate care and service and that they are satisfied with the health plan.
The Quality Improvement Program activities regarding developing, reviewing and monitoring services provided include:
- Measurement of health care, such as cancer screenings and immunizations received, and how well chronic conditions, such as asthma and diabetes, are controlled
- Member and provider satisfaction surveys
- Member complaints and appeals
- Access and availability to network providers
For more information about the Quality Improvement Program, log in to Blue Access for MembersSM (BAMSM) or call the Quality Improvement Program at 800-863-9798.