Quality Improvement Program

L.A. Care Health Plan Medicare Advantage (HMO SNP) wants you to improve your health care and make sure you are getting the best health care possible. This is called Quality Improvement.

• We track the health care services through a process called Healthcare Effectiveness Data Information Set (HEDIS)
• We ask how well we serve you through a survey, Consumer Assessment of Healthcare and Provider Systems (CAHPS)
• Each year we make changes to improve the health care services.
  
  Please select a link below to see some of our Quality Improvement efforts to make sure you get the best health care.

Increasing Flu and Pneumonia Shots

What are we currently doing?

• We track the number of members who reported that they got their flu shot.
• We track the number of members who reported that they ever got a pneumonia shot.  This shot is usually given only once or twice in a person’s lifetime.

What do we do to help?

• We send reminders in the mail and call our members to remind them to get their shots. 
• In 2012 some of our members were given their shots in their homes through L.A. Care’s in home vaccination program.

How are we doing?

• In 2012, 66% of our members reported that they got their flu shot.
• In 2012, 50% of our members reported that they got their pneumonia shot.
  
  What can you do?

• Make sure to visit your doctor’s office to get your shots.
• Keep track of the shots you had.

Controlling High Blood Pressure

What are we currently doing?

• We track the number of members (18-85 years) with high blood pressure who got treatment and were able to keep a healthy blood pressure.

What do we do to help?

•  L.A. Care offers its members counseling and classes to improve their health.
•  In 2012, L.A. Care offered home visits to members to check their health.

 How are we doing?

• In 2012, 53% of our members with high blood pressure got their treatment and were able to keep a healthy blood pressure.

 What can you do?

• If you have high blood pressure, make sure to visit your doctor and follow his/her advice on what to do to keep a healthy blood pressure.

Managing Cholesterol in Diabetes

What are we currently doing?

• We track the number of members (18-75 years) with diabetes who have had a cholesterol screening and keep their levels normal.

What do we do to help?

• L.A. Care sends its members helpful information on cholesterol management and healthy eating tips.
• L.A. Care offers its members counseling and classes to improve their health.

How are we doing?

• In 2012, 80% of our members had a cholesterol (LDL) test.
• In 2012, 47% of our members with diabetes were considered in control.

What can you do?

• Make sure to visit your doctor to get your test for cholesterol. 
• If you have diabetes or high cholesterol, follow your doctor’s advice on what to do to lower your “bad” (LDL) cholesterol.

Increasing Colorectal Cancer Screening

What are we currently doing?

•  We track the number of members (ages 50-75) who got a screening for colon cancer.

 What do we do to help?

•  In 2012 L.A. Care sent its members kits to test for blood in the stool. Members who sent back their kits had their results sent to their doctor.

 How are we doing?

• In 2012, 49% of our members got their screening for colon cancer.

 What can you do?

• Make sure to visit your doctor to get your screening for colon cancer.
• Follow your doctor’s advice on how to stay healthy.

Increasing Glaucoma Screening

What are we currently doing?

• We track the number of members (65 years and older) who got a glaucoma eye test for early detection.
• We remind our members who call our member services department to get their glaucoma test if they did not get it.

How are we doing?

•  In 2012, 57% of our members got their glaucoma tests.

What can you do?

• Make sure to visit your eye doctor to get your glaucoma test.

 

Improving Member Rating of Health Plan

What are we currently doing?

• We track the number of members who report on the CAHPS survey that they rated our health plan with the best possible score.

What do we do to help?

• We call our new members to thank them for being an L.A. Care member and to answer any questions they have.
• We make sure that when members call us, we provide the highest quality customer service. We ask members to give us their feedback on how well we do.

How are we doing?

•   In 2012, about 87.4% of members rated our health plan with the best possible score.

What can you do?

•  If you have any questions or concerns about the health plan, call L.A. Care’s Member Service Department.

Chronic Care Improvement Program

What are we currently doing?

L.A. Care has two programs: L.A. Cares about Diabetes and L.A. Cares about Your Heart.

L.A. Cares About Diabetes®

• Get information about:
  • What causes diabetes
  • How to eat right and stay healthy
  • How to measure your blood sugar
  • Diabetes medicines and how to take them
  • How to keep your diabetes under control
     
• Speak with a nurse about your diabetes

What we do to help?

As part of this program you will get::

• Information on what causes diabetes and how you can stay healthy
• Tips on how to control your diabetes
• A chance to talk to a nurse or educator.  We can talk about ways to get you the best care.

How are we doing?

• In 2012, 85% of members with diabetes had an A1c (blood sugar) lab test during the year.
• In 2012, 57% of the members with diabetes (type 1 and 2) had an eye exam to check for damage from diabetes during the year.

How can I enroll?

Eligible members are enrolled in this program when our records show they have diabetes.  To find out if you are eligible for the program, or if you would like to be taken out of the program, call us at the phone number below.

• Call 1-877-796-5878 (TTY/TDD 1-888-448-6894) Monday through Friday, 8am to 4pm, or email diabetesdm@lacare.org if you have questions about diabetes or want to enroll in L.A. Cares About Diabetes®.

You can also read about diabetes on our Health Education page.

L.A. Cares About Your Heart™

L.A. Cares About Your Heart ™ is a free program for Medicare Advantage (HMO SNP) members that helps people learn to lower their risk of heart disease.  As part of the program, you can:

• Get information about:
  - What causes heart disease, stroke, and heart attacks
  - How to eat right and stay healthy
  - How to keep your blood pressure and cholesterol in check
  - Heart medicines and how to take them
   
• Speak with a nurse about your heart health

How are we doing?

Information about the progress will be available starting 2014.

How can I enroll?

Eligible members are enrolled in this program when our records show they are at risk for heart disease.  To find out if you are eligible for the program, or if you would like to be taken out of the program, call the phone number below.
 

• Call 1-855-707-7852 (TTY/TDD 1-888-448-6894) Monday through Friday, 8am to 4pm, or email heartdm@lacare.org if you have questions about diabetes or want to enroll in L.A. Cares About Your Heart™.