Quality Improvement Strategy

Overview

Troy Medicare leadership takes it seriously to put the coordination of care back into the hands of the local providers that our members trust. By eliminating unnecessary authorization requirements and lowering the cost of medications, Troy Medicare will increase the quality of health care delivery and improve health outcomes for our members.

Troy Medicare is committed to:

• Making sure our members get the right care at the right time with the right provider.
• Continuously monitoring and improving our health care delivery to ensure quality and safety measures are met.
• Making sure our members have access to medically necessary health care by setting minimal authorization requirements.
• Increasing the adherence to medications by driving down the cost of medications for our members.

We meet these goals by:

• Monitoring utilization, reviewing claims trends, and tracking medication costs.
• Conducting annual consumer surveys and monitoring member experience and satisfaction.
• Monitoring patterns of care to ensure providers and members are not experiencing roadblocks.
• Lowering the administration costs of medications.

Troy Medicare will adhere to the requirements as set by CMS in the development and ongoing management of a quality improvement program.