Commitment to Quality
El Paso Health’s Quality Improvement Program is built upon standards that comply with Texas Department of Insurance (TDI) and HHSC requirements, as applicable. In addition, El Paso Health is accredited by the national accrediting organization URAC and the Quality Improvement Program is consistent with all applicable URAC standards.
Quality Improvement Program
The purpose of El Paso Health’s Quality Improvement Program is to continuously improve patient safety and Member outcomes by providing well-coordinated care within a robust network of contracted Providers, invested in providing evidence-based care in a patient-centered environment. The Quality Improvement Program is designed to assure that Members receive care that is consistent with our mission.
Our Quality Improvement Program is designed to improve:
- quality of care for all physical and behavioral health care and services
- member and provider satisfaction
- member safety
- access to services
As part of our commitment to quality, we review a variety of data to track member complaints, safety concerns, quality outcomes, and member and provider satisfaction in order to improve our programs and services to ensure the best quality care is provided. El Paso Health strives to build relationships that strengthen the delivery of healthcare in our community so that we may be the region’s trusted community health plan.
Clinical Practice Guidelines
On an annual basis, El Paso Health reviews and updates our adopted Clinical Practice Guidelines in an effort to promote utilization of the most current evidence-based practice. As we believe our members deserve the highest level of care, we promulgate and endorse the use of evidence-based practice. For that reason, El Paso Health’s Clinical Practice Guidelines provide a framework for specific clinical processes. El Paso Health’s Quality Improvement Committee (QIC) has reviewed and approved our Clinical Practice Guidelines for our adult and child populations. As aforementioned, Clinical Practice Guidelines serve as the framework to clinical care and are available to you as a set of reliable references designed to provide efficacy of clinical practice and substantiate its impact on clinical care outcomes.
El Paso Health has earmarked our Clinical Practice Guidelines to reflect the needs of our members. We have adopted preventative, public health and disease-specific clinical guidelines for our adult and child population. Our Clinical Practice Guidelines are promulgated by authoritative bodies, such as professional organizations or ad-hoc expert committees, and are based on current scientific literature.
To view our Clinical Practice Guidelines please click on the link below, or if you would like to obtain a hardcopy, please contact the Quality Improvement Department at 915-532-3778.
- Prenatal and Postpartum Care Guideline
- Routine Preventive Services Guideline 5d-24mo
- Routine Preventive Services Guideline 30mo-11yr
- Routine Preventive Services Guideline 12yr-20yr
- Asthma Management Guideline
- Diabetes Management Guideline
- Viral URI Management Guideline
- Mental Health Follow Up Guideline
- Social Determinants of Health Guideline
- Prescribing Opioids for Chronic Pain Guideline
In accordance with the Texas Health and Human Services Commission (HHSC) and Texas Department of Insurance (TDI) mandates, El Paso Health must monitor our Providers on an annual basis for 24 hour availability and office accessibility compliance. Your partnership is paramount in the success of our Quality Improvement initiatives and requirements mandated by TDI and HHSC.