MDwise Quality Improvement Program Overview

MDwise is committed to improving our member health outcomes through ongoing quality improvement efforts. MDwise creates and maintains the MDwise Quality Improvement (QI) Program. This program improves the physical and mental health care of our members. Our annual QI work plan, policies and procedures guide the completion of our QI program initiatives. The MDwise QI Program must follow standards set by the National Committee for Quality Assurance (NCQA) and the Office of Medicaid Policy and Planning (OMPP).

  • The MDwise QI Program, policies and procedures help identify the health care issues our members face.
  • The annual MDwise QI Work Plan ranks and defines topics to be reviewed in the calendar year. The QI Work Plan is unique to the MDwise member population.
  • The MDwise Pay for Value (P4V) program supports positive health outcomes for our members through rewarding MDwise providers. To view the provider P4V program details, visit org/mdwise/mdwise-physician-pay-for-value.
  • MDwise conducts an annual survey, called Consumer Assessment of Healthcare Providers and Systems (CAHPS). This helps measure member satisfaction with the plan and network providers.
  • MDwise works to provide services to members in a way they can understand.

MDwise members can earn points for completing healthy activities through the MDwise REWARDS program. The rules for the Hoosier Healthwise and HIP REWARDS programs are found on MDwise.org/MDwiseREWARDS.