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Quality

The Quality Improvement Program includes initiatives to ensure that members are receiving age-appropriate preventive health screenings and interventions to optimize health.

The information on this page provides useful information and tools for managing patient care based on industry-standard clinical practice guidelines.

Preventive Depression Screening Program

This program promotes collaboration, continuity and coordination between medical and behavioral health care.

2019 HEDIS Toolkit

HEDIS® Adult Resource Guide

2019 HEDIS® AT-A-GLANCE: KEY ADULT MEASURES

HEDIS® Guide Adult Quick Tips

2019 HEDIS® AT-A-GLANCE: KEY BEHAVIORAL MEASURES (18 Years and Older)

This guide alerts you to important preventive care and services that you can provide to patients to help boost Star Ratings.

Coordination of Care requires proactively identifying the patient’s needs, organizing care and communicating vital information at the right time to the right people.

This form is to assess care needs for older adults.

Medication Reconciliation Post-Discharge (MRP): This HEDIS measure ensures that members who are discharged from the hospital have their medications reviewed by a prescribing practitioner, clinical pharmacist or registered nurse within 30 days of discharge. An outpatient visit is not required, but is highly encouraged.

The survey is used to measure how the care provided by Medicare Advantage Organizations (MAO) affects the health outcomes of their enrollees.

Every year CMS or NCQA may ask your patient the following questions. How do you rate?


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Last Updated On: 11/27/2018
Welcome Prescription Drug Plan members! We have important information to share with you about your 2019 plan. Read More. ×