Provider Quality Programs

Closing Gaps in Care for Improved Patient Outcomes

Preventive care services such as immunizations, screenings, personal health assessments, and routine health care visits are essential to improving community health. However, gaps often exist between the care needed and the care that is delivered. 

That’s why MVP works collaboratively with our Providers to close gaps in care, through shared information and actionable data that helps drive the quality and appropriateness of health care services. 

We are committed to ensuring that our Members receive quality care and services that fully support standards established by federal and state regulatory agencies, and accrediting bodies, including the National Committee for Quality Assurance (NCQA) and Healthcare Effectiveness Data Information Set (HEDIS®). Additionally, MVP has developed a Diversity and Cultural Competency Training available to its health professionals, located on our Provider Education page. 

Current Quality Programs and Initiatives 

• NCQA Recognition Programs
• Medicare Advantage Condition-Specific Programs

Clinical Guidelines and Supporting Resources 

We provide clinical guidelines, supporting tools, and helpful resources for both Providers and Members. We’ve also developed Provider HEDIS Tip Sheets and Compliance Support Documents to help Providers close gaps in care. 

Our clinical guidelines are not intended to replace the role of the clinical judgment by the physician in the management of any disease state. All treatment decisions are ultimately up to the physician. 

Clinical guidelines are updated every two years or on a more frequent basis when new scientific evidence or national standards are published. We review all applicable guidelines and make updates accordingly. 

Explore the sections below to find topic-specific clinical guidelines and supporting resources for Providers and Members. 

Grant MVP remote access to EHRs

Learn how to grant MVP remote access to your electronic medical records (EMRs) to help enhance collaboration for the annual HEDIS medical record reviews and other initiatives. Or, learn best practices for streamlining the process to submit medical records.

We are here to help.

Call the Customer Care Center for Provider Services, Monday through Friday, 8:30 am – 5 pm, at 1-800-684-9286. TTY users may call 711, or visit our Provider Contact Us page.