HEDIS and Quality Initiatives
2018 Performance Poster that provides tips for MDwise providers on important preventive and clinical measures.
The State of Indiana, through the Family and Social Services Administration (FSSA), contracts with health plans to provide health care services to Hoosier Healthwise and Healthy Indiana Plan (HIP) enrollees in Indiana. As a reward for providing care that meets the standards of high quality pregnancy care, FSSA offers Pay For Outcomes (P4O) for the Health Plans. On an annual basis, FSSA establishes benchmarks for a set of quality measures defined in the health plan contract and offers additional payment when the health plans meet established goals.
The State of Indiana, through the Family and Social Services Administration (FSSA), contracts with health plans to provide health care services to Hoosier Healthwise and Healthy Indiana Plan (HIP) enrollees in Indiana. As a reward for providing care that meets the standards of high quality preventative care FSSA offers Pay For Outcomes (P4O) for the Health Plans. On an annual basis, FSSA establishes benchmarks for a set of quality measures defined in the health plan contract and offers additional payment when the health plans meet established goals.
Vaccine schedule for all children from birth to 16 years of age provided by Indiana Immunization Coalition. The provided vaccination schedules are compatible with recommendations of the Advisory Committee on Immunization Practices (ACIP), the US Center For Disease Control (CDC), The American Academy of Pediatrics (AAP) and The American Academy of Family Physicians (AAFP) and endorsed by the Indiana State Department of Health.
An integral part of patient care is making sure patients have access to needed medical care. In accordance with the OMPP policy and NCQA standards, MDwise establishes standards and performance monitors to help in ensuring that MDwise members receive timely and clinically appropriate access to providers and covered services.
Fax Back Program
The HEDIS fax back program allows providers to submit evidence of one or more of the following services, where a claim cannot be submitted, which include:
This information is used in calculating HEDIS-based performance rates for participating MDwise providers.
Tip Sheet
Learn more about the new state-wide quality initiative to address elective inductions and cesarean sections that are not medically necessary. The toolkit contains important information on recent research studies as well as provider tools and patient education.
CAHPS is an important member satisfaction survey conducted by health plans annually, in the spring of each year. The survey asks consumers and patients to report on and evaluate their experiences with their health care.
The MDwise medical benefit covers smoking cessation services for HIP and Hoosier Healthwise members in the form of tobacco cessation counseling services.
Well-Child Care/EPSDT
Actively pursue missed appointments with letters and reminder calls. Reminder calls made later in the day or early evening may result in more contacts being made to the members.
Recommendations for preventive pediatric health care from Bright Futures/American Academy of Pediatrics.
HealthWatch/EPSDT provider manual
This poster explains the importance of performing lead screenings on all children.