Affinity is often engaged in studies and collaborative projects to learn more about patient populations and how to better deliver preventive care. We also offer our providers useful information and resources to help you care for your patients. Be sure to access a copy of our latest Clinical Guidelines and Clinical Tools. These materials contain various treatment protocols, assessment modules and care management strategies. For QARR/HEDIS guidelines and chart documentation protocols, access the QARR (Adult | Children) and HEDIS (Medicare) quick reference guides and Keys to Quality.

The reporting standards outlined below inform and facilitate Affinity’s quality management activities.

QARR/HEDIS

QARR stands for Quality Assurance Reporting Requirements. This is the New York State Department of Health's version of the national Health Plan Employer Data and Information Set (HEDIS) developed and overseen by the National Committee on Quality Assurance (NCQA).

The QARR measures Affinity's performance in delivering preventive, prenatal, behavioral health, diabetes and asthma care services.

The new and improved 2015 Quality Incentive Program is now available. Please contact the Quality or Network Departments for more details.

We realize that our Provider Network is vital to our clinical performance, and we recognize providers who exceed State standards. Affinity and its Clinical Affairs Committee continue to look for innovative ways to assure that our Members receive high quality services.

QARR Performance Rates (2008-2011)

• Child Health Plus
• Medicaid
• Medicare

Quality Reporting Requirements

Affinity strives to keep our network providers abreast of the latest local, state, and federal regulations. Please check this site periodically for important information concerning government rules and policies.

• New York City Mandatory Reporting Requirements
• New York State Mandatory Reporting Requirements

For a complete listing of the diseases and conditions that providers are legally required to report, access the Compendium of Public Health Requirements and Recommendations on the New York City Department of Health and Mental Hygiene website.

New York Medicaid Child/Teen Health Program (C/THP)

Affinity Health Plan monitors awareness and adherence with New York State Department of Health requirements, Title 18 NYCRR §508, to ensure access to care, screenings, diagnostic and adequate treatment and services are provided for early detection and care for vulnerable, at risk populations, ages 0 to 21 years of age. Please see the link below for more information on compliance with these requirements.

• NY Medicaid C/THP Provider Manual

Additional Resources

You may find it helpful to scan the following Web sites for additional health care regulations, guidelines and critical industry news and developments.

• APHA (American Public Health Association) - apha.org
• AHRQ (Agency for Healthcare Research and Quality) - ahrq.gov
• CDC (Centers for Disease Control) - cdc.gov
• IHI (Institute for Healthcare Improvement) - ihi.org
• NAHQ (National Association for Health Care Quality) - nahq.org
• NCQA (National Committee for Quality Assurance) - ncqa.org
• NICHQ (National Initiative for Children's Health Care Improvement) - nichq.org
• NYAHQ (New York Association of Healthcare Quality) - nyahq.org
• NYCDHMH – (New York City Department of Health and Mental Hygiene) - www.nyc.gov/html/doh/html/home/home.shtml
• NYSDOH – (New York State Department of Health) - www.health.state.ny.us