Quality First

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Across
  1. 4. It is a way to check up on the quality of care delivered by health plans. Provide information on how well a health plan treats its members, keeps them healthy, and gives access to needed care. It can be published by States, private health organizations, consumer groups, or health plans.
  2. 9. The federal health insurance program for people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant, sometimes called ESRD).
  3. 11. An evaluative process in which a healthcare organization undergoes an examination of its policies, procedures, and performance by an external organization to ensure that it is meeting predetermined criteria. It usually involves both on- and off-site surveys.
Down
  1. 1. The way in which an individual, group, or organization carries out or accomplishes its important functions or processes.
  2. 2. Ability to get needed medical care and services.
  3. 3. The intentional deception or misrepresentation that an individual knows, or should know, to be false, or does not believe to be true, and makes, knowing the deception could result in some unauthorized benefit to himself or some other person(s).
  4. 5. The frequency of new occurrences of a condition within a defined time interval. The rate is the number of new cases of a specific disease divided by the number of people in a population over a specified period of time, usually one year.
  5. 6. A key clinical value or quality characteristic used to measure, over time, the performance, processes, and outcomes of an organization or some component of health care delivery.
  6. 7. In health care, an entity that assumes the risk of covering the cost of medical treatments. This can be an uninsured patient, a self-insured employer, a health plan, or an HMO.
  7. 8. A special kind of complaint you make if you disagree with a decision to deny a request for health care services or payment for services you already received.
  8. 10. The result of performance (or nonperformance) of a function or process.