Quality Improvement

We want you to be happy with the care and services you get. We monitor some areas of care and service to be sure that you get high quality care. These include:

  • Well-child care
  • Preventive screenings
  • Prenatal and postpartum care
  • Chronic disease management for conditions such as:
    • Asthma
    • Diabetes
    • High blood pressure
  • Care after being in a hospital for a behavioral health condition
  • Care for children taking ADHD medicines

We check how quickly our members get care and if they got the care they needed from their PCP. We also check to ensure our members get quality service from CareSource.

Clinical Practice Guidelines: Member Health Information

We use national clinical practice health guidelines and other information to help you learn how to take care of long-term and common health conditions, like asthma or diabetes. Learn more at Health Care Links page. To learn more about preventive health screenings for men and women visit preventive care guidelines.

We may also call or send you information about health care checkups and screenings you may need. If you have a long-term (chronic) condition, be sure to:

  • See your PCP or other health care provider regularly.
  • Follow the treatment plan your provider gives you.
  • Take your medicines correctly.
  • Follow guidance for testing. For example, taking your blood sugar and blood pressure.

You can call the CareSource24® number on your member ID card 24/7/365 to talk with a registered nurse.