NHC Advantage Gold (HMO I-SNP) benefits end on December 31, 2021. If you are a member of NHC Advantage Gold and have questions about your membership, please call Member Services at 1-844-854-6886 (TTY 711)

Quality 

We strive to meet the highest quality and safety standards.

NHC Advantage (HMO I-SNP) and NHC Advantage Gold (HMO I-SNP) are 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.

The NHC 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.

  • NHC Advantage’s mission, vision, and core values create the foundation for organizational QI.
  • NHC Advantage uses quality assurance and performance improvement to make decisions and guide our day-to-day operations.
  • NHC Advantage’s QI Program includes all business lines, partners, departments and services.
  • NHC Advantage’s QI Program is comprehensive regarding systems of care, management practices, and business practices.
  • NHC 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.
  • NHC 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 – NHC Advantage’s proprietary care management platform.

    Quality Objectives

    • To improve the health status of NHC Advantage Members.
    • To ensure access to high quality and safe health care services in the NHC Advantage service area.                                                                                                           

    For more information about the NHC Advantage Quality program, please call Member Services at 1-844-854-6886 (TTY 711). Calls to this number are free.

    Clinical Practice Guidelines

    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.

    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 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.