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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.

    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.

    HEDIS Guide Adult Quick Tips

    Important information for Medicare providers.

    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.

    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.

    A HEDIS quick reference guide for Pediatric care

    HEDIS reference guide for Pediatric care.

    At WellCare, we value everything you do to deliver quality care to our members – your patients – to make sure they have a positive health care experience. That’s why we’re emphasizing significant new measures that will impact Star Ratings in the At-A-Glance Guide below.

    2018 HEDIS At a Glance Key Pediatric Measures

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    Last Updated On: 1/29/2018