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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.

This information will assist providers with managing patient care based on industry-standard clinical practice guidelines.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Care Coordination

Get some tips you can use to raise patient awareness of all the great work you are doing to provide care coordination and involve the patient in decision making.


Electronic Health Records (EHR) Incentive Programs

CMS hosts regular webinars to educate providers on topics related to EHR Incentive Programs. If you use EHR, are interested in EHR capabilities, or want to learn how your practice can benefit, please visit the CMS website for more information. 

2019 HEDIS Toolkit

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

HEDIS® Adult Resource Guide

HEDIS® Guide Adult Quick Tips

2019 HEDIS® AT-A-GLANCE: KEY BEHAVIORAL MEASURES (17 Years and Younger)

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

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.

KEY PEDIATRIC MEASURES

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

HEDIS® Pediatric Resource Guide

2018 HEDIS Toolkit

HEDIS® ensures health plans are offering quality preventive care and service to members. It also allows for a true comparison of the performance of health plans by consumers and employers.

2018 HEDIS At-a-Glance Key Adult Measures

This document details the importance of coordination of care.

2018 HEDIS Adult Quick Tips Guide

A 2018 guide to HEDIS resources for providers.

2018 HEDIS At-a-Glance Key Behavioral Measures (17 Years and Younger)

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.

The Healthcare Effectiveness Data and Information Set (HEDIS) of performance measures is utilized by more than 90 percent of America's health plans.

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

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.

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

General reminders for providers who treat children.

How to Code for a Well Visit with a Sick Visit

Other Helpful Documents

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Last Updated On: 5/9/2017