Great Plains Medicare Advantage (HMO I-SNP) and Great Plain Medicare Advantage Gold (HMO I-SNP) is designed to meet the needs of our Members and health care partners. In addition, we strive to meet the highest quality and safety standards. We follow standards developed by the National Committee for Quality Assurance (NCQA) to reach this goal.
Great Plains Medicare Advantage Quality Improvement (QI) Department has a mission to provide an effective, system-wide, measurable plan for monitoring, evaluating and improving the quality of care and services in a cost-effective and efficient manner to our enrolled Members and contracted providers.
- Great Plains Medicare Advantage’s mission, vision, and core values create the foundation for organizational QI.
- Great Plains Medicare Advantage uses quality assurance and performance improvement to make decisions and guide our day-to-day operations.
- Great Plains Medicare Advantage’s QI Program includes all business lines, partners, departments and services.
- Great Plains Medicare Advantage’s QI Program is comprehensive regarding systems of care, management practices, and business practices.
- Great Plains Medicare Advantage’s QI Program is data-driven and supports the plan’s mission, vision, and values through continuous improvement and monitoring of medical care, patient safety, behavioral health services, and the delivery of services to Members.
- Great Plains Medicare Advantage’s QI Program decisions are based on data, which is collected in a systematic format in alignment with our infrastructure and aggregated in Align360 –Great Plains Medicare Advantage’s proprietary care management platform.
- To improve the health status of Great Plains Medicare Advantage Members.
- To ensure access to high quality and safe health care services in Great Plains Medicare Advantage service area.
For more information about Great Plains Medicare Advantage Quality program, please call Member Services at 1-844-637-4760 (TTY 711). Calls to this number are free.
The following clinical practice guidelines are intended to support our health care team and serve as resources to ensure our providers have the most up-to-date, evidence-based information recommended by nationally-recognized organizations. AMDA – The Society for Post-Acute and Long-Term Care Medicine – This is the standard care process in the post-acute and long-term care (PA/LTC) setting.
- COPD: Global Strategy for the Diagnosis, Management and Prevention of COPD.
- Diabetes: Standards of Medical Care in Diabetes – 2021 with a particular focus on chapter 12: Older Adults.
- Heart Failure: 2017 focused update of the 2013 Guidelines for the Management of Heart Failure.
- Hypertension: ACC and American Heart Association (AHA) guidelines for the detection, prevention, management and treatment of high blood pressure.
- Dementia: Alzheimer’s Association Dementia Care Practice Recommendations and American Psychiatric Association – Practice Guidelines on the use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia.
- Osteoporosis: 2020 Clinical Practice Guidelines for Postmenopausal Osteoporosis.
- Depression: American Psychiatric Association(APA)(2019). APA Guideline For the Treatment of Depression. Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts.
- Preventive: World Health Organization, Preventing and managing COVID-19 across long-term care services: Policy brief, 24 July 2020 and Centers for Disease Control and Prevention(2020). Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2020–21 Influenza Season.
Guidelines are provided for informational purposes only and are not meant to direct individual treatment decisions. All patient care and related decisions are the sole responsibility of providers. These guidelines do not dictate or control a provider’s clinical judgment regarding the appropriate treatment of a patient in any given case.ct individual treatment decisions. All patient care and related decisions are the sole responsibility of providers. These guidelines do not dictate or control a provider’s clinical judgment regarding the appropriate treatment of a patient in any given case.
Want more information about Great Plains Medicare Advantage?
Call us at 1-844-637-4760 (TTY 711).
Our trained member service representatives are available from 8:00 a.m. to 8:00 p.m., or fill out this contact me form to have us call you.