Our Dedication to Quality

Your health needs are important to us. Our Quality Assessment and Performance Improvement (QAPI) program helps us improve our services so that we make it easier for you to stay healthy and meet your needs for now and whatever is next.

QAPI program features

The QAPI program works to improve the quality of your health care.

It gives us a structure and guidelines for medical clinical care, behavioral clinical care, and other member services.

The program also helps our members improve their health and wellness by:

Developing programs for members with disabilities
Offering programs that help members manage their health
Making health education available to members
Sharing with members information about care gaps

AmeriHealth Caritas Next expects all of our providers to give quality care to you and your family. We get information to help us evaluate this and other aspects of access to care by:

Monitoring your health care and services. We help make sure you get the right kind of care.
Surveying members every year about how we can do better
Teaching members about health issues

If you believe you or your family did not get the care you deserve, call Member Services at 1-833-613-2262 (TTY 711). You will have the option to file a grievance, and we will review the issue.

Or call us if you would like more information about our quality improvement program.

Qualified Health Plan (QHP) results

New Plan – Not Rated

Plan quality ratings and enrollee survey results are calculated by the Centers for Medicare & Medicaid Services (CMS) using data provided by health plans in 2023. The ratings are being displayed for health plans for the 2024 plan year. Learn more about these ratings at https://www.healthcare.gov/quality-ratings.