Learn about the Health Policy and Quality Committee Charter the Blue KC Board of Directors has approved.
Blue Cross and Blue Shield of Kansas City (Blue KC)
Health Policy and Quality Committee Charter
Approved by the Board on December 4, 2003
Reaffirmed by the Board on May 12, 2004; on May 18, 2005; and on May 16, 2007
Purpose
The purpose of the Health Policy and Quality committee is to provide oversight of health policy and quality issues for Blue KC. This committee is charged with overseeing the establishment and integration of the Quality Management Programs and measurement of quality programs on a regular basis. The ultimate goal of this committee is to improve the quality of care and services provided to Blue KC members.
Authority
The Health Policy and Quality Committee derives its authority from the Bylaws of the Corporation, which provide that the primary responsibilities of the Health Policy and Quality Committee shall include but not be limited to review of the following:
- Quality of Care Issues
- Network Management
- Performance Based Monitoring of Hospitals and Physicians
- Enhance Plan Hospital and Physician Relationships
Composition
The Health Policy and Quality Committee shall be composed of a minimum of three (3) members (but no maximum) made up of both physician and non physician members of the Board of Directors. The Committee shall be made up of a majority of independent directors. All physician members of the Board of Directors shall be members of this committee. The Chairman of the Board shall be an ex-officio member of the Health Policy and Quality Committee. Members of this committee and its chairman shall be appointed by the Chairman of the Board with ratification by the Board at its next regular or special meeting following the Annual Meeting.
Meetings
The Committee will meet at least four times a year, with authority to convene additional meetings as circumstances require. All Committee members are expected to attend each meeting, in person. Occasional participation via tele- or video-conference is permitted; however, in person attendance is preferred. Minutes will be prepared for approval.
Responsibilities
The committee will carry out the following responsibilities:
- Approve the corporate Quality Management Program for submission to the Board of Directors.
- Provides clinical direction for hospital management programs in keeping with corporate strategic goals, enhancement on quality of patient care, and feasibility in the private practitioner’s office.
- Approve the Annual Evaluations and Work Plans for Quality Management Programs for Blue KC and its subsidiaries.
- Monitor quality management activities to comply with the quality goals of each program as well as the overall business goals of Blue KC.
- Recommend appropriate actions to improve quality of care and/or service.
- Make policy recommendations in relation to questions arising from the health plans or subsidiaries.
- Ensure that the Quality Management goals are consistent with the highest standards of medical care as well as the business goals of Blue KC.
- Represent Blue KC to the provider community and provide feedback to the Board of Directors on provider concerns, perceptions and other issues.
- Monitor and have oversight of network management and reimbursement strategies as they relate to physicians, relationships with physicians and hospitals, and provider contract compliance.
- Assist management in implementing new concepts and technology in the medical community and in keeping the full board informed of pertinent issues.
Reporting Responsibilities
- This committee will regularly report to the Board of Directors about Committee activities, issues, and related recommendations.
- Provide an open avenue of communication between the medical and hospital community, management and the board of directors.
- Review any other reports the company issues that relate to Committee responsibilities.