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https://archive.opm.gov/insure/health/planinfo/safety/SF.asp

Insurance Programs

Health

SelectHealth Patient Safety Initiatives

As part of Intermountain Healthcare®, one of the nation's top-ranked integrated health systems*, SelectHealth shares a nonprofit mission of healthcare excellence. For more than 25 years, we have been committed to helping members stay healthy, offering outstanding customer service, and providing access to the highest quality care.

We were the first private health plan in Utah to receive "Excellent" Accreditation status by the National Committee for Quality Assurance (NCQA). In 2013, we were again named Utah’s top-ranked health plan, according to NCQA's Health Insurance Plan Rankings 2013-2014**.

Dr. Stephen Barlow, our Chief Medical Officer, is the patient safety officer of record for our members.

Listed below are our critical patient safety initiatives:

Care Management

We focus on getting you better and keeping you well. Our team of compassionate, registered nurses averages nearly 30 years of experience in all areas of medicine, with a local knowledge of facilities, providers, and services. We offer educational materials, online and community resources, and follow-up phone calls to help manage chronic health conditions, such as asthma, diabetes, heart disease, and cancer. Nurses work directly with members to explain benefits and coordinate care.

Prenatal Care

SelectHealth Healthy Beginnings® is a program for expectant mothers. It is available at no additional cost and is designed to work along with healthcare providers to promote a safe and healthy pregnancy. Enrolling in Healthy Beginnings provides the following:

  • Access to a registered nurse or a high-risk perinatal nurse care manager
  • Assistance in answering questions, offering emotional support, and providing referrals to community resources
  • A pregnancy planner full of fun facts and information
  • Educational materials

Member Satisfaction

We routinely survey our members to measure the effectiveness of our care management programs, their experience visiting their doctor, and the accessibility to care.

Work Site Wellness Programs

Our work site wellness programs promote productivity, reduce health risks, and encourage healthy habits. The following programs can help motivate employees all year:

  • Catch A Flight℠
  • Get Fit℠
  • Holiday Weigh In℠
  • Summer Slim Down℠
  • The Weigh to Health®
  • Walk A Day℠
  • Walking Trails℠
  • Wellness Week

Health Fairs and Screenings

We can teach employers and employees about proper exercise and nutrition during a free, on-site health fair. In addition, we provide blood pressure, body fat, cholesterol, and glucose screenings. Online presentations and quizzes are available for employees who are unable to attend.

Flu Shots

We partner with Community Nursing Services (CNS) to offer flu shot clinics for our members and their insured spouses and adult dependents.

Pharmacy-Specific Safety Initiatives and Programs

Online Pharmacy Tools

Our Drug Lookup tool provides member education based on potential drug interactions and side effects. Members can also view lower-cost drugs, find plan-specific coverage information, and search for participating pharmacies. Doctors can use this tool to validate member prescriptions and check for safety concerns.

Step Therapy

This program encourages members to try less-expensive alternatives, such as generic drugs, before using a high-cost medication. These drugs do not compromise clinical quality and typically meet members’ needs at a more affordable price.

Preauthorization

This allows our Pharmacy team to review criteria and evaluate appropriateness prior to coverage of high-risk or high-cost drugs.

Narcotic Management

We involve doctors, pharmacists, and nurses to help us identify and prevent the overuse and abuse of controlled substances.

Medication Reviews

Our clinical pharmacists complete monthly polypharmacy reviews of member data to evaluate those who use a high number of acute and chronic medications. The purposes of this review include the risk assessment of potentially unsafe drug interactions, the identification of appropriate therapeutic alternatives, and the prevention of duplicate prescribing by different providers.

Claims Processing System

Our real-time claims processing system checks for refills exceeding quantity limits, early refills, and drug interactions. This system is important because it helps us identify dangerous drug combinations and helps us prevent unfavorable outcomes from the use of medications in high doses.

*Modern Healthcare magazine

*According to NCQA's Health Insurance Plan Rankings 2013-14