eQHealth in Louisiana
Since 1986, we have held the contract with the federal Centers for Medicare and Medicaid Services as the Quality Improvement Organization for Louisiana. In the state, we are the leader in driving quality and scientific-based approaches to the delivery of health care across all settings. We have consistently produced leading results among a national network of Medicare quality improvement organizations, particularly in the areas of disease prevention, wellness and chronic care.
In this capacity, we conduct quality improvement projects across the state, working with hospitals, physicians, home health agencies, beneficiaries, governments, nursing homes and community-based organizations. read more...
eQHealth in Mississippi
We are also the Medicaid quality improvement organization for the State of Mississippi, and have worked with the Mississippi Division of Medicaid since 1997. A key component of this work is to conduct utilization review and quality improvement efforts for inpatient and outpatient programs.
Our utilization review work includes: inpatient hospitalization, inpatient acute psychiatric care, swing bed, psychiatric residential treatment facilities, home health, durable medical equipment, transplants, clinical consultation, peer review, outpatient therapy, private duty nursing, maternity reporting and provider education. We also conduct precertifications and quality of care reviews for the state’s MYPAC Waiver for children with mental illnesses.
We operate a large call center in Jackson, and we are Utilization Review Accreditation Commission (URAC)-certified as a utilization management organization. read more...
eQHealth in Illinois
Since 2002, we have been appointed as the Medicaid QIO for the State of Illinois. Operating as eQHealth Solutions (formerly HSI), we assist the Illinois Department of Healthcare and Family Services Medicaid with medical peer reviews, utilization management, quality improvement services, special projects and focused quality studies. We conduct coding and DRG validation, provide extensive program and policy consulting services and conduct clinical research projects.
We also conduct quality assurance projects for Illinois’ Home and Community-Based Services (HCBS) waiver programs. These include program development consultation, onsite reviews and program monitoring activities and waiver participant experience surveys.