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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.

    Important information for Medicare providers.

    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?

    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.

    This guide alerts you to important preventive care and services that you can provide to patients to help boost Star Ratings.


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    Last Updated On: 11/30/2017