Quality

Report Quality of Care (QOC) Concerns

A Quality of Care (QOC) concern is any concern about the safety, effectiveness, appropriateness, or quality of care provided to a member. Examples may include concerns about treatment decisions, delays in care, communication issues, medication concerns, patient safety events, or care that does not meet professional standards. 

NHP is committed to reviewing and addressing Quality of Care concerns to help ensure members receive safe, effective, and high-quality healthcare services. 

Please submit all Quality of Care concerns within 24 hours of discovery or observation, along with any supporting documentation. 

Behavioral Health Providers

Behavioral Health Quality of Care concerns are managed by NHP’s Adminstrative Service Organization, Rocky Mountain Health Plans (RMHP). Behavioral Health providers should use this form to report all Quality of Care (QOC) concerns within 24 hours of discovery or observation, along with any relevant documentation and submit it to UHCProviderQualityofCareConcerns@uhc.com. 

Physical Health Providers

All Physical Health providers, please use this form to report all Quality of Care (QOC) concerns within 24 hours of discovery or observation, along with any relevant documentation and submit it to Quality_Management@nhpllc.org.

Members have the right to file a complaint or express a concern at any time. If you are not a provider and wish to file a complaint or express a concern, please visit our Complaints & Appeals page. 

QM and QM/HE Workgroups

NHP’s Quality Management (QM) and Health Equity (HE) Workgroups are one of the best ways for providers to engage with the RAE and help improve care across Region 2. 

To make discussions more focused and actionable, NHP’s 33 Key Performance Indicators (KPIs) are divided across four workgroups. These groups meet every other month to review performance data, identify disparities and health equity concerns, discuss barriers to care, and develop solutions that improve outcomes for members. 

Using a Plan-Do-Study-Act (PDSA) approach, participants identify trends, share best practices, test improvement ideas, and refine workflows. Findings and recommendations from the workgroups are then reported to the larger Quality Management Committee, which meets quarterly to review progress and guide regional quality improvement efforts. 

Workgroups meet every other month, while the full QM Committee meets quarterly. The schedule can be a little confusing, so be sure to review the Workgroup Schedule to find the meetings that best match your interests. 

Whether you’re interested in preventive care, screenings, chronic disease management, behavioral health, or health equity, there’s a place for you. Providers are encouraged to participate in as many, or as few, workgroups as they’d like. 

If you’re looking for the best place to start working with the NHP Quality Department, this is it. We can’t wait to see you at the next meeting!

Quality Management (QM) Committee and the QM/HE Workgroups can now be accessed through our website on our Meetings & Events page, or the register button below. To see the full schedule for QM and Workgroups visit the schedule here.

Quality Reports, Resources & Required Documents

As part of our commitment to transparency, quality improvement, and regulatory compliance, NHP makes a variety of required reports, policies, and program documents available to providers, members, and community partners. This page serves as a central location for accessing key quality, compliance, and operational resources that support our work across Region 2.