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Quality

WellCare of Kentucky wants to ensure that our members have access to quality, cost-effective health care solutions. Our Quality Improvement (QI) program aims to improve patient safety and care so our members can enhance their quality of life by staying healthy or managing their chronic health problems.

Health and Wellness Programs

Helps members stay healthy by providing access to educational materials and health tips.

Quality Rating System (QRS) Measurement Year 2024

HEDIS Measurement Year 2024 Toolkit

    Additional Quality Resources

    Program Overview

    This program coordinates individualized, cost-effective and integrated services to foster positive clinical outcomes for our medically compromised population. Goals include:

    • Decrease fragmentation of health care service delivery
    • Facilitate appropriate use of available resources
    • Optimize member outcomes through education, care coordination and advocacy services

    This program provides education and health coaching to empower our members to manage chronic conditions, including asthma, diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), coronary artery disease (CAD), hypertension, depression and human immunodeficiency virus (HIV).

    Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program

    Improves the rate of members receiving health assessment screenings and testing.

    Testing for Lead Poisoning Flyer (PDF)

    EPSDT Well Child Exam Form (PDF)

    This program ensures children receive their vaccines and stay healthy. Immunizations should be provided in accordance with ACIP guidelines and the Periodicity Schedule.

    Supports pregnant women so they can have healthy babies.

    Find out what smoking cessation resources (PDF) are available to assist members.

    SCLC Webinar Series

    Free CME/CEUs for Kentucky Providers
    Access over 50 webinars featuring experts in tobacco control and public health presenting on topics including:

    E-Cigarettes
    Behavioral Health
    Peer-to-Peer Training
    NRT Priority Populations
    Pregnant Smokers
    Tobacco-Free Policy
    Innovations in Tobacco Dependence Treatment
    Integrated Care

    Free CME/CEUs for live and selected recorded webinars are now available to providers in Kentucky through 2/28/16! Use the discount code: KY15 to waive the $35 certificate fee. For a complete list of webinars or for more information, visit the UCSF School of Medicine website.

    Controlling High Blood Pressure is a NCQA quality measure with a weighted value of 3. Here are some quick reminders for closing blood pressure care gaps: