Family Care, Partnership, and PACE: What's New!

COVID-19 Updates

We are committed to protecting the health and safety of our members and participants during the COVID-19 pandemic. To stay informed about the latest program updates, limitations to in-person contacts, general COVID-19 resources, and more:

For data on COVID-19 in Medicaid home and community-based services settings, please visit the Medicaid Adult Home and Community-Based Services: COVID-19 Data page.

Request for Public Comment

2021 Wisconsin Medicaid Managed Care Quality Strategy

The Wisconsin Department of Health Services (DHS) is opening a 30-day public comment period for the draft of the 2021 Medicaid Managed Care Quality Strategy. Stakeholder feedback is requested in accordance with federal requirements.

The Medicaid Managed Care Quality Strategy meets the federal requirements of 42 C.F.R. § 438.430 to describe DHS' strategies for assessment and quality improvement of managed care services offered to Medicaid members. The 2021 Medicaid Managed Care Quality strategy is the second version of the original Quality Strategy published in 2018. The 2021 Quality Strategy includes improvements based on Medicaid quality team review, public comment from the 2018 Quality Strategy, and feedback from the Centers for Medicare & Medicaid Services.

The Quality Strategy sets a three-year vision for the Division of Medicaid Services to achieve its quality goals for managed care programs, and it is intended to evolve over time. The Quality Strategy describes the specific strategies Wisconsin will use to best meet the health care, service, and support needs of Wisconsin Medicaid members. The Quality Strategy includes BadgerCare Plus and Medicaid Supplemental Security Income health maintenance organizations, Health Homes, Family Care, Family Care Partnership, Children Come First, Wraparound Milwaukee, and Care4Kids managed care programs.

In addition to the 2021 Medicaid Managed Care Quality Strategy and per 42 C.F.R. § 438.430, states are responsible for submitting regular reports on the implementation and effectiveness of the Quality Strategy. The Quality Strategy Effectiveness Evaluation provides an assessment of the Division of Medicaid Services' previous quality strategy and highlights key areas of improvement which are included in the 2021 Medicaid Managed Care Quality Strategy.

Public comment is an opportunity to contribute feedback to DHS on the 2021 Medicaid Managed Care Quality Strategy. If you would like to submit comments on the Quality Strategy, public comment offers you the opportunity to do so.

Review the 2021 Medicaid Managed Care Quality Strategy and submit your comments by May 21, 2021. There are a few ways you can submit your comments:

  • Email your comments to DHS Quality Strategy
  • Send your comments in the mail to:
    Division of Medicaid Services, Bureau of Programs and Policy
    Attn: 2021 Medicaid Managed Care Quality Strategy
    PO Box 309
    Madison, WI 53701-0309

To request a paper copy of the 2021 Medicaid Managed Care Quality Strategy, call 608-267-7286 or toll-free at 1-855-885-0287.

Scorecards

The scorecards are a tool members can use to help them choose a managed care organization. Each managed care organization is represented in the scorecard by star ratings evaluating how well the organization performs across a variety of factors, including consumer satisfaction and compliance with state standards. 

Enrollment Statistics

Monthly enrollment reports

Electronic Visit Verification

In response to the federal 21st Century Cures Act, the Wisconsin Department of Health Services (DHS) is required to implement Electronic Visit Verification (EVV) for Medicaid-covered personal care services and home health services. DHS has created a dedicated webpage where providers can view all current EVV information. Providers are encouraged to visit the webpage frequently.

Last Revised: April 22, 2021