EQRO Division

EQRO Division

Qsource serves as the independent external quality review organization (EQRO) for TennCare, Tennessee’s managed care Medicaid program, and CoverKids, the state Children’s Health Insurance Program (CHIP). We evaluate the quality, timeliness and accessibility of services provided to the men, women and children receiving care through TennCare and CoverKids health plans.

As part of its contract, Qsource’s EQRO Division

  • assesses contractual and regulatory compliance requirements,
  • performs data aggregation and statistical analyses, and
  • conducts quality improvement (QI) activities.

We produce meaningful quality assurance and program evaluation reports based on these activities to inform critical decision-making for our stakeholders. EQRO Division staff members have an in-depth understanding of managed care systems, particularly those that deliver integrated medical, behavioral and long-term care services. Several have served with numerous state and national organizations, and have been invited to present on such topics as quality measurement, disparities, health policy and communications.

Using our national quality measure, analytical and reporting expertise, Qsource has developed several population/measure-specific reports such as the statewide healthcare report card with county-level results for diabetes, hypertension and asthma—one of the nation’s first.

These and other services make Qsource an industry leader in quality review and a recognized positive force in Tennessee’s evolving healthcare landscape.

 

TennCare Health Plan Meeting
Next Meeting June 10, 2014

Feb Meeting Agenda

Highlights/Summary from the Last Meeting

Marriott Cool Springs
700 Cool Springs Blvd.
Franklin, TN 37067
(615) 261-6100

 

Our EQRO Division is based in Nashville, Tennessee, with headquarters in Memphis, Tennessee. Qsource has several office locations and remote staff to ensure localized service; see our Contacts to meet your needs.

EQRO Division
49 Music Square West, Suite 402
Nashville, TN 37203
Phone: 615.244.2007
Fax: 615.244.2018

John Couzins, MPH, CHCA
EQRO Director

Gloria Potter, RN
EQRO Program Manager

HEDIS® refers to the Healthcare Effectiveness Data and Information Set and is a registered trademark of the National Committee for Quality Assurance (NCQA). CAHPS® refers to the Consumer Assessment of Healthcare Providers and Systems and is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).