Family Care, Family Care Partnership, and PACE: External Quality Review Activities

The 42 Code of Federal Regulations, §438, requires states that manage certain types of programs to have an external quality review. We contract with a company called MetaStar. They are not part of Wisconsin Department of Health Services (DHS). They help check the quality of our programs:

• Family Care
• Family Care Partnership (Partnership)
• PACE (Program of All-Inclusive Care for the Elderly)

Federal regulations and Centers for Medicare & Medicaid Services protocols define external quality review activities. On a routine basis, MetaStar:

• Looks at the quality of services provided to program members. They review the contract DHS has with managed care organizations.
• Confirms whether each managed care organization is in line with federal and state rules. These rules ensure that programs meet members’ needs.

External quality review reports

MetaStar submits a technical report each year based on their findings:

• External Quality Review, Fiscal Year, 2022–2023 (PDF)
• External Quality Review, Fiscal Year, 2021–2022 (PDF)
• External Quality Review, Fiscal Year, 2020–2021 (PDF)
• External Quality Review, Fiscal Year, 2019–2020 (PDF)
• External Quality Review, Fiscal Year, 2018–2019 (PDF)
• External Quality Review, Fiscal Year, 2017–2018 (PDF)
• External Quality Review, Fiscal Year, 2016–2017 (PDF)
• External Quality Review, Fiscal Year, 2015–2016 (PDF)
• External Quality Review, Fiscal Year, 2014–2015 (PDF)
• External Quality Review, Fiscal Year, 2013–2014 (PDF)
• External Quality Review, Fiscal Year, 2012–2013 (PDF)
• External Quality Review, Fiscal Year, 2011–2012 (PDF)
• External Quality Review, Fiscal Year, 2010–2011 (PDF)
• External Quality Review, Fiscal Year, 2009–2010 (PDF)