Quality Improvement Program – Wellcare by Allwell

Wellcare by Allwell’s mission is to improve the health of all members. The Quality Improvement (QI) Program is an important part of this mission.  The
Program seeks to improve the quality of care, safety, and appropriate use
services for all Wellcare by Allwell members. The QI Program monitors the
quality of care and services provided in the areas below:

  • Making sure members get the care they need, when and where they need it
  • Making sure that members are receiving quality care
  • Cultural needs of our members
  • Member satisfaction
  • Member/Patient Safety and Privacy
  • Offering a wide variety of provider specialties
  • Health plan services members are using

As with Wellcare by Allwell’s mission, the goal of the QI Program is to improve the health of all members. This is achieved through many different activities. Some of our QI goals include the following:

  • Good health and quality of life for all members
  • Care provided by Plan Healthcare Providers meets industry-accepted standards of care
  • Plan Member Services meets industry-accepted standards of performance
  • Provide members with Preventive Care reminders annually
  • Incomplete or duplicate services will be kept to a minimum through QI activities across Plan departments
  • The Member experience will meet the Plan’s expectations
  • Compliance with all State and Federal laws and regulations
  • Evaluate Member experience through the use of a satisfaction survey called CAHPS® (Consumer Assessment of Healthcare Providers and Systems). This survey tells us how satisfied you are with your health care, your provider(s), and with Buckeye Health Plan. Please see below for Wellcare by Allwell’s CAHPS® performance.
  • Evaluate the quality of health care through HEDIS® (Healthcare Effectiveness Data and Information Set). These scores tell us when you have received the type of care you need. Please see below for Wellcare by Allwell’s HEDIS® results. 

If you would like to learn more about Wellcare by Allwell QI Activities, please contact member services at 1-855-766-1851 (TTY: 711), Monday – Friday from 8 a.m. to 8 p.m.