Quality Programs

LifeWise quality programs benefit members across every plan and service. We work with providers to monitor and improve the care they 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. View the quality program report card.

Quality & Coding Tools

Visit our Quality & Coding Tools page for quality measure tip sheets, documentation and coding guides, web-based training, and more.

Physician collaboration

The quality program provides opportunities for physician collaboration with LifeWise practicing physicians who are members of the Clinical Quality Improvement Committee, Pharmacy and Therapeutics Committee and Credentialing Committee. These committees seek practitioners' clinical guidance, expertise and perspective on LifeWise quality improvement, behavioral health, care management, disease management, pharmacy, and other health improvement programs and projects.

Involvement in these forums assists the company in improving member health and the quality and safety of care and service experienced by our customers. Physicians interested in serving on one of the quality program committees should contact the LifeWise medical director.

Quality of care complaint review

If a member, practitioner or LifeWise associate expresses concern about the quality of care received by one of our members, we take the following steps:

• Document and investigate their concern.
• Conduct an investigation observing strict confidentiality.
• Request pertinent information and/or medical record documentation as needed.
• Seek review by LifeWise senior medical directors, peers or Board-certified specialists as needed.

Patient safety

LifeWise promotes awareness and provides educational information aligned with the national focus on patient safety. We provide access to information that equips members to take an active role in their healthcare. In addition, LifeWise provides access to information, standards of care, and national resources designed to help physicians and other providers improve the effectiveness and safety of care delivery.

To educate members about steps they can take to have a more active role in promoting safe care for themselves, LifeWise recommends the Five Steps to Safer Healthcare fact sheet. The fact sheet was developed by federal agencies in the Quality Interagency Coordination (QuIC) Task Force working with other healthcare purchasers, physicians, and providers.

Clinical practice and preventive guidelines

LifeWise maintains clinical practice guidelines for medical conditions relevant to its member population. The guidelines are designed to help guide practitioner and member decisions about appropriate healthcare for specific clinical circumstances.

LifeWise also offers guidelines for preventive services. The up-to-date guides are a quick reference, describing recommended prevention and early detection interventions.

More information about Clinical practice and preventive guidelines can be found on our Clinical Practice Guidelines page.