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Quality Improvement Program

MeridianCare's Quality Improvement Program (QIP) is designed to ensure our members receive high quality, medically appropriate, and cost effective health care.

Our Quality Improvement Program Helps Members:

  • Get access to high quality care
  • Participate in community events and programs to increase and improve preventive healthcare
  • Manage and prevent disease through educational materials and our Disease Management Programs
  • Manage complex health care needs
  • Coordinate care for acute and chronic care needs

QIP Objectives

  • Ensure enrollee access to care
  • Provide accessibility and availability of quality medical and behavioral healthcare
  • Develop programs to increase and improve preventive healthcare
  • Monitor and expand Disease Management Programs for prevalent disease states
  • Manage members with complex health care needs
  • Coordinate care for members with acute and chronic care needs
  • Improve coordination and transition of care across healthcare settings
  • Monitor adherence to evidence based and established Clinical Practice Guidelines
  • Improve member and provider satisfaction
  • Design member and provider health education materials that include a call to action
  • Improve HEDIS® and CAHPS® performance
  • Develop and maintain collaborative relationships with providers and State agencies
  • Develop programs for serving a culturally and linguistically diverse membership through analysis of significant healthcare disparities in clinical areas
  • Identify specific healthcare disparities to reduce and implement targeted activities to address barriers and improve health outcomes

Role of Participating Providers

Meridian actively encourages providers to participate in quality improvement activities. Provider engagement and feedback is crucial to the implementation, success and evaluation of Meridian's QIP. Meridian's contracted providers participate in and contribute to quality activities in their commitment to:

  • Abide by Meridian policies and procedures
  • Actively participate in Meridian's HEDIS® program emphasizing the importance of preventive care and disease management
  • Review clinical practice guidelines and medical policies
  • Offer constructive feedback to Meridian's quality improvement program
  • Participate in Meridian committees, as desired
  • Cooperate with medical chart review, audit, and abstraction activities
  • Collaborate with Meridian staff to ensure access to care and services

You may request a complete copy of our Quality Improvement Program by contacting the Quality Department at 1-855-323-4578 (TTY 711), Monday - Friday from 8 a.m. - 8 p.m.

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