Caring Starts with Emphasis on Quality
Member satisfaction is very important at Care Wisconsin. We routinely check with and survey members to make sure their needs are being met. This helps us identify ways we can improve and continue to provide the best service to our members. We have a Member Advisory Committee, which gathers member feedback and recommendations about their programs.
Care Wisconsin participates in many quality initiatives at both the federal and state level to ensure that members are satisfied with their care and as healthy as possible. Some of these include the federal Chronic Care Improvement Project to address diabetes management, Honoring Choices Wisconsin to promote advance care planning, and internal systems to track and follow up with member incidents.
An external review organization, Metastar, conducts an Annual Quality Review (AQR) of our Family Care, Partnership, and Medicaid SSI programs. We constantly strive to improve the quality of our programs, care, and services, to meet and exceed expectations. Here are some comments from our last AQR report:
- Care Wisconsin strongly values staff development and provides a variety of training and other professional growth opportunities for staff at all levels.
- The organization values and supports member rights.
- A Provider Quality Committee integrates staff from multiple departments and levels of the organization.
- Care Wisconsin has a structured quality management system which includes consistent monitoring, collection and analysis of data, and development of strategies to improve the quality of member care and organizational operations.
The Compliance Program is an essential component of Care Wisconsin’s operations: It ensures that the organization works within the boundaries set forth in our contracts with the state and federal governments. This creates a high standard of ethical conduct and continuous improvement on the part of the organization, employees, providers, and even members.
A major piece of the Compliance Program is prevention, detection, and resolution of fraud, waste and abuse (FWA). Everyone is responsible for reporting known or potential cases of FWA in order to protect members’ rights to be free of unethical behavior and financial exploitation, and to receive the best care possible.
If you have a compliance or FWA concern, call our Compliance Hotline at 1-608-245-3576 or toll-free at 1-833-253-3465.
Grievances, Appeals, and Member Rights
Care Wisconsin protects member rights and has a dedicated team that addresses the concerns of members if they or their representatives are ever dissatisfied with decisions or services.
Our well-defined process that meets all Wisconsin Department of Health Services (DHS) requirements. We encourage members to exercise their rights! Visit our Grievances and Appeals page to learn more about the process and contact information.