The objective of the Quality Assessment and Improvement (QAI) and Utilization Management (UM) program is to facilitate safe, efficient, effective, and economical delivery of services throughout the Upper Peninsula Health Plan (UPHP) network. The QAI/UM program processes incorporate functions to examine the multi-faceted components of health care delivery; to make recommendations where programs are identified; and to implement interventions to improve the quality and safety of health care in accordance with the requirements of federal, state, and accrediting agency standards. The UPHP QAI/UM program promotes an integrated approach to evaluate and improve the quality and safety of medical and behavioral health care and services delivered to members, to manage health care resources, and to improve the processes and outcomes of care provided to members. This program is designed to support a comprehensive approach to identify any sources of variation in outcomes and to implement corrective action when necessary.
Many programs and initiatives are offered by our Utilization Management and Quality Management teams at the Upper Peninsula Health Plan. Some examples are provided below. For more information or a copy of UPHP’s QAI/UM plan, please call Clinical Services at 1-800-835-2556.
Page Last Updated: 05/16/2018