Solutions

Customized and Actionable

Working hand-in-hand with state agencies and the managed care organizations or health plans they contract with, we assess the quality, timeliness, and accessibility of the care and services delivered to the Medicaid members enrolled in each of the health plans. As a multistate External Quality Review Organization (EQRO), we're passionate about applying our knowledge, decades of combined experience and flexibility to identify gaps in system delivery and provide the tools necessary to take action. EQR services include:

  • Comprehensive review of compliance with state and federal requirements
  • Information systems capability assessment review
  • Readiness reviews for new health plans
  • Performance measures validation
  • Performance improvement project validation
  • Validation of network adequacy
  • Consumer and provider satisfaction survey validation
  • Ongoing training, education, and technical assistance for health plans
  • Evaluation of state‚Äôs quality strategy
  • Develop plans for quality improvement

Outcomes

24+

24+ Years Experience

A trusted partner, we have held the EQR contract with the South Carolina Department of Health and Human Services (SCDHHS) since 1996.

100%

100% On Time

We have performed 161 annual reviews, 18 readiness reviews and 74 telephone access studies with 100 percent completed on time.

Outcomes

24+

24+ Years Experience


A trusted partner, we have held the EQR contract with the South Carolina Department of Health and Human Services (SCDHHS) since 1996.

100%

100% On Time


We have performed 161 annual reviews, 18 readiness reviews and 74 telephone access studies with 100 percent completed on time.


Customers

Decades of Experience


We apply decades of combined experience in delivering EQR services in North Carolina, South Carolina and Mississippi.