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Quality

Staywell wants to ensure quality, cost-effective health care solutions for our members. Our Quality Improvement (QI) Program aims to advance patient safety and care so members can stay healthy and manage chronic health problems.

Health and Wellness Programs

Helps members stay healthy by providing access to educational materials and health tips.

 

2019 HEDIS Toolkit

HEDIS® (Healthcare Effectiveness Data and Information Set)

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

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

HEDIS® Guide Adult Quick Tips

HEDIS® Adult Resource Guide

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

This form is to assess care needs for older adults.

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

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

We’re asking our providers to make sure to use accurate CPT Category II codes to improve efficiencies in closing patient care gaps and in data collection for performance measurement.

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

Pediatric and Behavioral Health Measures

What are your patients saying about the care they received? Each year, a child CAHPS survey is conducted to collect information about patient healthcare experience. Studies show patients who are happy with their personal doctor are more compliant to treatment plans and have better health outcomes.

Preventive Health Counseling and Education for Children and Adolescents Ages 3–17 Years

HEDIS® Guide Pediatric Quick Tips

2018 HEDIS Toolkit

HEDIS ensures health plans are offering quality preventive care and service to members.

2018 HEDIS At-a-Glance Key Adult Measures

This document details the importance of coordination of care.

HEDIS® GUIDE ADULT QUICK TIPS

Important information for Medicare providers.

At WellCare, we value everything you do to deliver quality care for our members – your patients – to make sure they have a positive health care experience. That’s why we’ve created this easy-to-use, informative HEDIS® At-A-Glance Guide. It gives you the tools you need to meet, document and code HEDIS Measures.

Information concerning the mental and emotional well-being of patients.

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

2018 HEDIS At-a-Glance Key Pediatric Measures

General reminders for providers who treat children.

HEDIS reference guide for Pediatric care.

How to Code for a Well Visit with a Sick Visit

Preventive Health Counseling and Education for Children and Adolescents (Ages 3-17 Years)

Staywell 2018 Quality Challenge

Staywell is committed to superior quality performance. The Agency for Health Care Administration (AHCA) also recognizes high levels of quality performance and is empowered to award incentives and quality designations to high-performing health plans.

Helpful Information

Case Management

This program coordinates individualized, cost-effective and integrated services to foster positive clinical outcomes for our medically compromised population. Goals include:
  • Decrease fragmentation of health care service delivery.
  • Facilitate appropriate use of available resources.
  • Optimize member outcomes through education, care coordination and advocacy services. 

Disease Management

This program provides education and health coaching with the goal of empowering members to manage chronic conditions, including asthma, diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), coronary artery disease (CAD), hypertension, depression and human immunodeficiency virus (HIV).

EPSDT Program

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program
Improves the rate of members receiving health assessment screenings and testing.

Florida Vaccines for Children

Ensures children receive their vaccines in accordance with Advisory Committee on Immunization Practices (ACIP) guidelines and periodicity schedule

Maternity Education and Rewards

Supports pregnant women so they can have healthy babies.  

  • Case Management

    Case Management

    This program coordinates individualized, cost-effective and integrated services to foster positive clinical outcomes for our medically compromised population. Goals include:
    • Decrease fragmentation of health care service delivery.
    • Facilitate appropriate use of available resources.
    • Optimize member outcomes through education, care coordination and advocacy services. 
  • Disease Management

    Disease Management

    This program provides education and health coaching with the goal of empowering members to manage chronic conditions, including asthma, diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), coronary artery disease (CAD), hypertension, depression and human immunodeficiency virus (HIV).
  • EPSTD Program

    EPSDT Program

    Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program
    Improves the rate of members receiving health assessment screenings and testing.
  • Florida Vaccines for Children

    Florida Vaccines for Children

    Ensures children receive their vaccines in accordance with Advisory Committee on Immunization Practices (ACIP) guidelines and periodicity schedule
  • Maternity Education and Rewards Program

    Maternity Education and Rewards

    Supports pregnant women so they can have healthy babies.  

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Last Updated On: 8/6/2018