Quality management

Magellan supports the delivery of quality care with the primary goal of improving the health status of youth and families and, where the condition is not amenable to improvement, maintaining the youth’s current health status by implementing measures to prevent any further decline in condition or deterioration of health status. This includes identifying youth and families at risk of developing conditions, implementing appropriate interventions, and designating adequate resources to support the intervention(s).

In this section you will find information about the complaint/grievance process and critical incident reporting, along with our Quality Assurance Performance Improvement (QAPI) Program.

Quality assurance, performance improvement and outcomes

Magellan is committed to continuous quality improvement through its Quality Assurance Performance Improvement (QAPI) Program, which includes assessment, planning, measurement, and re-assessment of key aspects of care and services.

In collaboration with the Division of Child & Family Services Connect Nevada Program, youths, families, providers, and stakeholders, Magellan facilitates quality activities that promote the Connect Nevada goals, sustain recovery and resiliency for youths and families, and promotes high-quality care as defined by the Institute of Medicine, which is characterized as safe, effective, member-centered, timely, efficient, and equitable care. Quality activities reinforce Magellan Health’s goals and are organized under the following three themes:

• Positively influencing the health and well-being of individuals by improving clinical outcomes, assuring youth safety, and adding value through efficiency.
• Enhancing service delivery for youth and their families.
• Ensuring that core business processes are innovative and meet or exceed contract and regulatory guidelines.

We measure and evaluate clinical care, youth safety, and preventive health services.

We pursue opportunities to improve these processes and determine to what extent interventions have had a positive effect on outcomes.

We identify opportunities for improvement through clinical review activities, including review of core performance indicators, utilization management, care management, youth and provider satisfaction, and provider site visits.

Find information about quality management in our Handbooks (Manuals) on the Resources page.

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