Quality Improvement (QI) Program

The Upper Peninsula Health Plan Quality Improvement Program is:

  • an ongoing process throughout the year that addresses:
    • the quality and safety of clinical care
    • the quality of service, and
    • the members’ experience with their providers and the health plan

Each year UPHP Evaluates:

  • member access to care
  • communication among providers
  • measurement of provider performance against national standards, and
  • member/provider complaints and grievances

Two tools used to measure the plan’s performance include:

  • Consumer Assessment of Healthcare Provider and Systems (CAHPS®)
    • It is a survey that asks individuals and families about the health care they are receiving
    • UPHP receives feedback as to whether members are happy with their care and their doctors
  • Healthcare Effectiveness Data and Information Set (HEDIS®)
    • It measures performance of care and services using clinical guidelines
    • It allows UPHP to compare the plan’s performance against other health plans
    • is measured annually

For additional information on the QI Program call UPHP Customer Service at 1-800-835-2556.

Page Last Updated: 08/28/2019