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) Measurment Year 2024
HEDIS Measurement Year 2024 Toolkit
HEDIS Measurement Year 2023 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.
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.
- Mommy and Baby Matters Booklet (PDF)
- Prenatal Rewards Form (PDF)
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: