As Washington's Medicaid external quality review organization (EQRO), Qualis Health provides external quality review and supports quality improvement for enrollees of Washington Apple Health managed care programs and the Behavioral Health Organization (BHO) network. Our work supports the Washington State Health Care Authority (HCA) and Department of Social and Health Services (DSHS) Division of Behavioral Health and Recovery (DBHR).
Qualis Health reviews services provided by Apple Health managed care organizations (MCOs) through the following annual activities:
Qualis Health reviews mental health services provided by the state’s Behavioral Health Organizations (BHOs)—formerly Regional Support Networks (RSNs)—through the following annual activities:
In addition, Qualis Health conducts yearly in-person trainings and educational sessions for MCO and BHO staff, and publishes annual technical and analytic reports presenting the results of the above activities and analyses. You can find more information about these activities on the Events and Publications pages.
We understand how important it is to receive quality healthcare services.
As the external quality review organization, Qualis Health's role is to assess the quality of care Medicaid recipients receive.
If you have a concern about the care you or a family member has received, please contact the appropriate agency below.