Commitment to quality

Care we'd want for our own family.

Quality is woven into our culture. Every member of our team is committed to compassionate, highly reliable care—measured against the outcomes that matter most to the people we serve.

Patient safety first

Evidence-based protocols, transparent reporting, and continuous learning from every adverse event — with root-cause review built into the workflow, not bolted on after the fact.

Partner with members

Patients and families help write the care plan. Goals are documented in the member's own words and revisited at every visit so care stays tied to what matters most.

Invest in our people

We hire, train, and retain talented clinicians, social workers, and Community Health Workers — paying competitively, capping caseloads, and protecting time for supervision and reflection.

Data drives improvement

We benchmark against top performers, publish internal metrics quarterly, and run rapid PDSA cycles when a measure drifts off target. No metric is for show.

Seamlessly coordinated

One shared record, one accountable Lead Care Manager, and warm handoffs across primary care, behavioral health, and community supports — so members never have to be their own messenger.

Equity and access

We measure outcomes by language, race, geography, and disability status — and act on the gaps. Removing barriers for under-served populations is a permanent priority, not a project.

Standards we hold ourselves to

Independently measured, openly reported.

Quality is more than an aspiration — it is a discipline. We align our programs with national standards, invite independent review, and share the results with our members, partners, and managed-care plans.

NCQA-aligned care management

Our Enhanced Care Management and Community Supports programs follow NCQA Population Health Management standards and California DHCS CalAIM specifications.

Continuous quality monitoring

A dedicated Quality Improvement Committee reviews HEDIS-aligned measures, member experience surveys, and grievance trends every month.

Independent audit ready

Annual third-party file audits, HIPAA risk assessments, and managed-care plan delegation reviews — with corrective action plans tracked to closure.

Results

Outcomes that prove it.

A snapshot of the most recent program year, drawn from claims data, member surveys, and our internal care-management platform.

32%

Fewer ED visits

vs. baseline, members enrolled 12+ months

28%

Fewer inpatient admissions

high-risk cohort, year-over-year

40%

Better medication adherence

chronic conditions, PDC ≥ 80%

94%

Member satisfaction

would recommend PHG to a friend or family member

< 48h

Outreach after referral

average time to first member contact

21

Languages supported

in-house staff and on-demand interpretation

What we measure

  • Avoidable ED visits, readmissions, and inpatient days
  • Chronic-condition control: A1C, blood pressure, depression (PHQ-9)
  • Preventive screenings and immunization rates
  • Member-reported goals achieved and quality-of-life scores
  • Time to first contact, care-plan completion, and follow-through

How we improve

  • Monthly QI Committee with clinical, operations, and member voice
  • Rapid PDSA cycles when a measure drifts more than two points
  • Case conferences for every high-acuity member, every 30 days
  • Member and caregiver advisory council that shapes program design
  • Open reporting of safety events with a just-culture framework

Data & technology

Built on a platform that listens.

Great care needs great signal. Our purpose-built care-management platform brings claims, clinical notes, social determinants, and member-reported goals into one record — so the Lead Care Manager already knows the story before the first call.

One unified record

Claims feeds, ADT alerts from hospitals, eligibility, assessments, and care-plan history live in a single longitudinal record per member.

Smart workflows

Risk stratification and rules-based prompts surface the right outreach, screening, or escalation at the right time — not buried in a worklist.

Mobile-first for the field

Community Health Workers document visits, capture consent, and request services from a phone or tablet — even offline in rural areas.

Privacy and security

HIPAA-compliant infrastructure, encryption in transit and at rest, role-based access, and annual third-party penetration testing.

100%

of visits documented in-platform within 24 hours

HL7 / FHIR

bi-directional exchange with managed-care plans

SOC 2 Type II

controls and HITRUST-aligned safeguards

"Quality isn't a department here — it's the way we show up for every member, every visit. If a measure isn't moving, we don't wait for a quarterly report. We change something on Monday."
— The Executive Team, Pacific Health Group