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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.

Interoperability and Electronic Medical Records (EMR)

Interoperability is a secure way for healthcare systems and software applications to share electronic medical records (EMR) that support our provider partners in the effective delivery of care for better patient outcomes.

View more information and EMR intake form.

Preventive Depression Screening Program

The Depression Prevention program promotes collaboration, continuity and coordination between medical and behavioral health care.

New: HEDIS® Measurement Year 2026 Toolkit

HEDIS® Measurement Year 2026

Quality Measures

Provider Annual Preventive Care Visits for their Members

Controlling Blood Pressure Flyer

(COL-E) Flyer

Blood Sugar Controlled – Glycemic Status Assessment for Patients With Diabetes (GSD)

Use this tip sheet for best practices on how to talk to your patients about why they need to maintain adherence and how to track their medications.

OMW – Osteoporosis Management Flyer

Social determinants influence health in very direct ways. A patient’s housing, food, and safety needs can create barriers blocking quality care and can contribute to poor health.

Examples of Centers for Medicare and Medicaid Services Star measures which use statin therapy to evaluate health plans.

Transitions of Care (TRC)

Medicare Incentive Programs

Unlock the Benefits of Partnership!

Primary care providers have the opportunity to earn a bonus by addressing preventive care and closing care gaps.

Primary care providers have the opportunity to earn a bonus by addressing preventive care and closing care gaps.

As part of a year-end push to improve medication adherence, Wellcare is offering an additional financial incentive (Incentive Payment Program) to its providers who use RxEffect to identify and take action in the following Star ratings medication therapy areas:

CAHPS and HOS Resources

CAHPS (Consumer Assessment of Healthcare Providers and Systems) Resource Guide

Consumer Assessment of Healthcare Providers and Systems (CAHPS) is a survey tool that asks patients to evaluate their experience with their health plan and at providers’ offices.

HOS Health Outcomes Survey

Additional Quality Documents

To ensure medical services are available to our members on a timely basis, Primary Care Provider (PCP), behavioral health, and specialist appointment availability standards for Meridian and its family of plans are noted in the chart

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Y0020_WCM_178064E_M Last Updated On: 11/10/2025