Skip to Main Content

Quality Improvement Program

Meridian's Quality Improvement Program (QIP) is designed to ensure our members receive high quality, medically appropriate, and cost effective health care.

Our Quality Improvement Program Helps Members:

  • Participate in community events and programs to increase and improve preventive healthcare
  • Manage and prevent disease through educational materials and our Disease Management Programs

QIP Objectives

  • Develop programs to increase and improve preventive healthcare
  • Monitor adherence to evidence based and established Clinical Practice Guidelines
  • Improve member and provider satisfaction
  • Design member and provider health education materials that include a call to action
  • Improve HEDIS® and CAHPS® performance
  • Develop and maintain collaborative relationships with providers and State agencies
  • Develop programs for serving a culturally and linguistically diverse membership through analysis of significant healthcare disparities in clinical areas
  • Identify specific healthcare disparities to reduce and implement targeted activities to address barriers and improve health outcomes

Role of Participating Providers

Meridian actively encourages providers to participate in quality improvement activities. Provider engagement and feedback is crucial to the implementation, success and evaluation of Meridian's QIP. Meridian's contracted providers participate in and contribute to quality activities in their commitment to:

  • Abide by Meridian policies and procedures
  • Actively participate in Meridian's HEDIS® program emphasizing the importance of preventive care and disease management
  • Review clinical practice guidelines and medical policies
  • Offer constructive feedback to Meridian's quality improvement program
  • Participate in Meridian committees, as desired
  • Cooperate with medical chart review, audit, and abstraction activities
  • Collaborate with Meridian staff to ensure access to care and services

You may request a complete copy of our Quality Improvement Program by contacting the Quality Department at 1-855-580-1689 (TTY: 711), Monday - Friday from 8 a.m. - 8 p.m.

Updated Date: 10/01/24

H6080_WEBSITE_2025_Accepted_09302024


Updated Date: 10/01/24

H6080_WEBSITE_2025_Accepted_09302024

Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Meridian Member Handbook. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. You can get this document for free in other formats, such as large print, braille, or audio. Call 1-855-580-1689 (TTY: 711). Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.

© Copyright 2024 Centene Corporation