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Achieving Success in Quality Improvement

Achieving Success in Quality Improvement


We want to give you helpful hints on how to achieve success in quality improvement as a Horizon Blue Cross Blue Shield of New Jersey and/or Horizon NJ Health provider.

According to the Health Resources & Services Administration, quality improvement consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups.

There are four actions you can take to prepare for a successful year for quality improvement.

First, build strategies to address care gaps.

The best way to build strategies to help patients get the care and screenings they need is to incorporate best practices into your daily operations. This may help you identify ways you can improve health outcomes, and patient engagement and satisfaction.

You can find a list of best practices, by referencing to the Quality Program Manual at

Second, create an environment of collaborative learning.

To close gaps in care and improve quality service, you have to understand what information is needed for your files.

Visit to access a variety of resources, tools and webinars that can help you understand compliance criteria, HEDIS® measures and more.

Third, leverage data and technology.

A great way to leverage data and technology is to track your progress with the monthly Quality Performance Reports you receive from us.

Reviewing these reports will help you determine where you are doing well and if there are any opportunities for improvement.

You can ensure compliance and help address gaps in care by submitting supplemental data medical records and electronic health record feeds in a timely fashion.

Fourth, use a team-based approach.

You are not in this alone. We can work together to achieve quality care for your patients, our members. If you have any questions, we are here to help.

You can also participate in one of our Quality Management programs, such as our Results & Recognition Program, Valued-Based Programs and more.

When you follow these four steps, you will help us to:

  1. Improve the patient experience,
  2. Reduce the cost of health care,
  3. Improve the health of the populations we serve, and
  4. Provide continuous quality improvement.

Please remember that quality improvement is always evolving.

Revisiting your quality strategy is key to achieving success.

Please contact us if you would like detailed information on the ways to prepare for a successful year for quality improvement or if you have any questions.