The Quality Program supports Premera's mission: to provide peace of mind to members about their healthcare coverage. We do this by providing a framework for ongoing evaluation and communication designed to improve member health and the quality and safety of care and service experienced by our customers. Our Quality Program benefits Premera members across every plan and service. We work with you to monitor and improve the care you provide. The Quality Improvement Committee conducts a formal, system-wide quality assessment annually, which includes an annual program evaluation of the quality of its health services. Learn more
We identify members in need of preventive services and encourage them to receive these important services. Preventive services include:
Premera Preventive Health Guidelines describe appropriate preventive care for all members based on age, gender and risk factors. Premera endorses the US Preventive Services Task Force Guide to Clinical Preventive Services.
Our new Health Risk Management program provides a proactive approach to helping members identify and reduce specific health risk factors, through healthier lifestyle choices. The program integrates data and services to address an individual’s specific risk factors, and is designed to increase productivity and improve overall quality of life.
Whenever possible, Premera endorses evidence-based national guidelines for medical treatment of those conditions addressed by Premera disease management programs, quality and pharmacy programs. If national guidelines are not available, medical research and literature is reviewed and practitioners with appropriate expertise collaborate with Premera staff to develop guideline recommendations. The Premera Clinical Quality Improvement Committee reviews and approves new guidelines and recommendations for endorsement of national guidelines. All guidelines are reviewed and updated at least every two years.
View the Clinical Practice Guidelines used in our Disease Management Program.
If a member, practitioner or Premera associate expresses concern about the quality of care received by one of our members, we take the following steps:
Premera promotes awareness and educational activities that are aligned with the national focus on patient safety. We distribute information to members that equips them to take an active role in their healthcare. We also distribute information, industry standards and national resources designed to help physicians and other providers improve the safety of care delivery.