CONTACT: Beth Kaplan, (608) 267-3810
STATE QUALITY INITIATIVE IMPROVING HMO SERVICES TO MEDICAID MEMBERS
HMOs Meet Nearly 90% of State Quality Goals
MADISONThe quality of health care services provided by Health
Maintenance Organizations (HMOs) to Wisconsin Medicaid members in 2009
improved over both 2008 and 2007 levels, according to the results of a new
Pay-For-Performance initiative started by the Department of Health
Services (DHS) last year. The 13 HMOs, serving more than 630,000 Medicaid
members, met nearly 90 percent of their quality goals.
“The goal of this initiative is to ensure that state Medicaid members
get the highest quality, most cost effective health care services,” said
Wisconsin Medicaid Director Jason Helgerson. “We also want to give our
members the tools to make the best choices for themselves and their
Today DHS launched an interactive website to help Medicaid members
select an HMO by providing the latest data and quality scores for their
HMO options, https://quality.wisconsin.gov/.
Currently, state Medicaid members are mailed the HMO Report Card, which
shows letter grades earned by each HMO based on comparisons with national
and Wisconsin average quality scores, once every year. Beginning today
current members and new enrollees can access the quality data online and
can search by specific health condition.
HMOs can receive incentive payments if they meet all of the quality
goals. Four HMOs, Dean Health Plan, Group Health Cooperative of South
Central Wisconsin, Security Health plans and Unity Health Plan, will
receive more than $1.2 million in pay for performance incentive payments
based on their performance in 2009.
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Last Revised: December 16, 2010