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Quality

Missouri Care 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 our members can stay healthy and manage chronic health problems.

Case Management
The Case Management (CM) Department consists of licensed clinical (nurses, social workers and counselors) and non-clinical professionals to assess and provide interventions to members based on identified risks and unmet needs

Disease Management
Missouri Care offers services for members who have:
  • Asthma
  • Diabetes
  • COPD (Chronic Obstructive Pulmonary Disease)
  • CHF (Congestive Heart Failure)
  • Depression
If you want more information or refer a member to our disease management program, please call 1-800-322-6027/TTY 1-800-735-2966.

HEDIS®
Missouri Care utilizes the National Committee for Quality Assurance (NCQA) HEDIS® measures to monitor members' care. We've developed a toolkit to help identify required preventive services.

2019 HEDIS Toolkit

HEDIS® (Healthcare Effectiveness Data and Information Set)

Missouri Care values everything you do to deliver quality healthcare for our members – your patients. This easy-to-use HEDIS® At-A-Glance Guide gives you the tools to meet, document and code HEDIS 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

Adult and Behavioral Health Measures

At Missouri Care, we value everything you do to deliver quality care for our members – your patients – to make sure they have a positive healthcare experience. That’s why we’ve created this easy-to-use, informative HEDIS® At-A-Glance Guide.

At Missouri Care, we value everything you do to deliver quality care for our members – your patients – to make sure they have a positive healthcare experience. That’s why we’ve created this easy-to-use, informative HEDIS® At-A-Glance Guide.

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

Important Information on CPT II and HCPCS Codes

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.

At Missouri Care, we value everything you do to deliver quality care for our members – your patients – to make sure they have a positive healthcare 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.

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.

HEDIS® Guide Pediatric Quick Tips

Pediatric and Behavioral Health Measures

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Last Updated On: 2/4/2019