BHP’s Quality Management and Improvement Program

The BHP Quality Program provides the framework by which BHP assesses and improves the quality of care and service, clinical outcomes, and customer satisfaction throughout the network.  BHP is a fully accredited NCQA Managed Behavioral Health Organization. Full Accreditation is granted for a period of three years to those plans that have excellent programs for continuous quality improvement and meet NCQA’s rigorous standards.

BHP currently has numerous quality programs and initiatives and several departments within BHP collaborate to provide data, analytics and support for the quality program and activities. In general BHP’s quality programs fall into the following categories:

  • Clinical Services
  • Member Services
  • Network Services
  • Preventative Health and Screening Services
  • Clinical Practice Guidelines
  • Patient Safety

 BHP reports on the results of their quality program in the annual year report. You can view a copy of the most recent year-end report to the right in our download column.

 

Clinical Practice Guidelines

BHP has developed four clinical practice guidelines to help practitioners make decisions about appropriate health care for specific clinical circumstances.

  • ADHD Clinical Practice Guideline
  • Bipolar Clinical Practice Guideline
  • Chemical Health Clinical Practice Guideline
  • Depression Clinical Practice Guideline

FAQ

1What is NCQA?
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. NCQA reviews include rigorous on-site and off-site evaluations conducted by a team of physicians and managed care experts. A national oversight committee of physicians and behavioral health providers analyzes the team’s findings and assigns an accreditation level based on the MBHO’s performance compared to NCQA standards. NCQA MBHO Accreditation standards are intended to help organizations achieve the highest level of performance possible, reduce patient risk for untoward outcomes, and create an environment of continuous improvement. There are approximately 60 standards for quality included in the following categories: Quality Management and Improvement Utilization Management Credentialing and Recredentialing Members’ Rights and Responsibilities Preventive Behavioral Health Care Services
2Why have I been chosen for a chart audit?
As part of a NCQA quality initiative BHP conducts chart audits to monitor adherence to BHP’s clinical practice guidelines. Providers are chosen randomly for chart audits based on if they have seen BHP patient’s in the past year and if the patients have a diagnosis associated with one of BHP’s clinical practice guidelines. Chart audits are not meant to be punitive in nature, and are used to report on the quality of services provided by the BHP provider network.