The purpose of the Quality Improvement Program of MCS Advantage, Inc., a subsidiary of MCS Healthcare Holdings, LLC, is to provide the infrastructure for continuous monitoring, oversight, evaluation, and improvement of care, safety, and service. Quality improvement activities are coordinated with other performance monitoring activities and management functions, including, but not limited to, utilization management and care management.
The Quality Improvement Program activities for MCS include, but are not limited to:
The program aims to continually improve the quality, availability, access, coordination, and continuity of care and the service provided to our members. It also focuses on monitoring and evaluating the performance of the Model of Care for both the chronic and dual special needs plans.
Ensuring member satisfaction is also part of the general purpose for the program. The Quality Improvement Program includes the Member Satisfaction Committee and an annual satisfaction survey for Medicare Advantage members. These initiatives increase the individual and collective satisfaction of our members.
MCS Advantage, Inc. measures and reports its performance by using the nationally recognized and required measuring tools by regulatory agencies.
The members and providers’ experiences with the services provided by MCS Healthcare Holdings, LLC and its subsidiary MCS Advantage, Inc., is very important. At the end of the services offered by our call centers and service centers, internal satisfaction surveys are conducted. The information obtained from these surveys helps us monitor the level of satisfaction of our members and providers with the services received and to implement and evaluate quality improvement initiatives.
The results from the first and second quarters of 2026 are as follows:
MCS Classicare Call Center
98.92% of the surveyed members reported being satisfied after receiving services from the MCS Classicare Customer Service Call Center.
Service Centers
99.89% of members who visited one of the 12 service centers throughout the island reported being satisfied with the service received.
Care Management
The overall satisfaction rate of MCS Classicare members surveyed after participating in the Care Management Program was 99%.
Transition of Care
99% of the members surveyed after receiving assistance through the 30-day Transition of Care Program reported being satisfied with the services they received.
Call Center for provider service
The 99% of the providers surveyed reported being satisfied with the services received from the Provider’s Service Call Center. The 99% of the calls were solved in the provider’s first attempt.
Credentialing process
The 97% of the providers surveyed reported being satisfied after the initial credentialing review process. After the re-credentialing process, which is conducted every three years, the 94% of the survey providers reported satisfaction.
Visits to providers
The 98% of the providers reported being satisfied with the service received during the health plan representative’s onsite visit.
The satisfaction levels of our members and providers are a very important tool to evaluate the success of the quality strategies integrated into the services we offer.
Every year, Medicare evaluates plans based on a 5-star rating system.
The Quality Improvement Program for mental health at MCS Solutions describes the goals, objectives, responsibilities, scope, and work plan for all quality-related activities. The program comprises the FHC Board of Directors, the Quality Improvement Committee (QIC), the Quality Department, and committees that report to the QIC, all within FHC.
The purpose of the program's annual assessment is to summarize its activities and achievements throughout the year. The annual assessment reviews and documents the overall effectiveness of the program, including the quality of clinical and non-clinical services, as well as operational improvements. This report covers the period from January 1, 2025, to December 31, 2025.
Program goals
The goals of the program include, but are not limited to:
Program results and achievements