HAP Senior Plus, Alliance Medicare PPO and Alliance Medicare Rx require network pharmacies to review your prescriptions each time they are filled, to make sure that you are receiving safe and appropriate care. These reviews are especially important for members who have more than one doctor who prescribe their medications. During these reviews, pharmacists look for medication problems such as:

• Possible medication errors
• Duplicate drugs that are unnecessary because you are taking another drug to treat the same medical condition
• Drugs that have an equally safe and effective alternative that is more cost-effective
• Drugs that are inappropriate because of your age or gender
• Possible harmful interactions between drugs you are taking
• Drug allergies
• Drug dosage errors

If a medication problem is found during a drug utilization review, the pharmacy will work with your doctor to correct the problem.

The Health Alliance Plan (HAP) Quality Program and its supporting policies/procedures, aims to assure that safe, effective, patient centered, timely, efficient and equitable clinical care and services are provided to members/enrollees. HAP seeks to demonstrate value and improve quality through the elimination of over, under and misuse of services. The Quality program and policies focuses on coordinating activities for continuous quality improvement of clinical care and safety (including general medical and behavioral health care) and of services across HAP’s delivery system by:

• identifying areas for improvement; and
• implementing interventions to improve the safety, quality, availability and accessibility of, and member satisfaction with, care and services;
• promoting members’ health, through health promotion, disease prevention and condition management;
• assisting in the development of informed patients engaged in healthy behaviors and active self-management;
• measuring, assessing, and/or coordinating:
• evidence-based clinical quality,
• patient safety,
• practitioner availability and accessibility, and
• member and practitioner satisfaction;
• supporting the continued development of proactive provider practices.