QI Program

We are committed to the provision of a well-designed and well-implemented Quality Improvement (QI) program. Our culture, systems and processes are structured around this mission to improve the health of all enrolled members.

Scope

The scope of the QI Program is comprehensive and addresses both the quality and safety of clinical care and quality of services provided to de Sunflower Health Plan members including medical, behavioral health, dental and vision care. We incorporate all demographic groups, care settings, and services in QI activities, including preventive care, emergency care, primary care, specialty care, acute care, short-term care, long-term care (depending upon de Sunflower Health Plan products), and ancillary services.

Goals & Objectives

Our primary quality improvement goal is to improve members’ health status through a variety of meaningful quality improvement activities implemented across all care settings and aimed at improving quality of care and services delivered. One way to assess the quality of the health plan and its provider network is through the Consumer Assessment of Healthcare Providers and Systems, or CAHPS. Annually, results of Sunflower’s member satisfaction survey can be found in the Sunflower Health Plan Quality Improvement Evaluation posted to this website.

As a healthcare provider, you should know about CAHPS and what the CAHPS survey is asking your patients about physician communication. Click on the CAHPS Provider Resource Guide and the CAHPS Resources page links below to learn what physicians can do to improve communication with our members.

• CAHPS Provider Resource Guide (PDF)
• CAHPS Resources Page

Credentialing Standards

For consideration to participate in the Sunflower Health Plan network, all licensed physicians and other licensed healthcare professionals who have an independent relationship with Sunflower Health Plan must complete an application for participation and submit copies of applicable supporting documentation.

Cultural Competency Plan

Sunflower Health Plan is committed to establishing multicultural principles and practices throughout its organizational systems of services and programs. That mission is supported by facilitating the process by which Sunflower Health Plan can respond to the health care needs of all individuals, regardless of their ethnic, cultural, religious beliefs or language. Our Cultural Competency plan is reviewed and updated annually.

Participation in QI

Sunflower Health Plan requires providers and practitioners to cooperate with all Quality Improvement activities, as well as allow the use of provider and/or practitioner performance data, to ensure the success of the QI Program. If you are interested in learning more about de Sunflower Health Plan QI Program, please contact Sunflower Health Plan at 1-877-644-4623 and ask to speak with the Quality Improvement Department.

Sunflower NCQA Ratings

For more information on the plan’s ratings, including performance on health outcomes and member surveys, please visit Sunflower's NCQA Health Plan Rating page.