Clinical Quality Management

Blue Cross and Blue Shield of Nebraska (BCBSNE) maintains a Clinical Quality Management (CQM) program that aligns with our mission as a champion for the health and well-being of our members and the communities we serve. To enhance care delivery, improve member experience and foster collaboration with providers, we initiate programs to elevate the care and services our members receive.

The Clinical Quality Improvement (CQI) department coordinates and facilitates the CQM program, including but not limited to:

• URAC accreditation
• Accountable care organizations and patient-centered medical homes value-based care quality programs 
• Preventive health and wellness 
• Consumer safety and transparency 
• Clinical quality improvement activities
• Health care safety and quality
• Provider office standards for:
  • Practitioner offices 
  • Urgent care centers 
  • Appointment availability and access to care

In compliance with regulatory requirements, programs are evaluated on a regular basis and results are reported annually to the Board of Directors.

Communication and collaboration with providers in the BCBSNE networks, as well as professional and community organizations in Nebraska and nationally, contribute to the success of our program and demonstrate our commitment to high-quality care and service in Nebraska and beyond.