The Washington State Health Insurance Pool (WSHIP) was established in 1988 by the Washington State Legislature to provide access to health insurance coverage to all residents of the state who are denied individual health insurance.
WSHIP coverage is also available to residents of Washington State counties where individual health benefit plans or commercial Medicare supplemental insurance is not for sale to the general public.
Qualis Health provides the following services for the Washington State Health Insurance Pool:
- Case management
- Disease management
- Utilization management
- Specialty review for experimental and investigational determinations
Emphasis is placed on WSHIP's desire for an integrated patient-centered program; services specifically designed to meet the needs of WSHIP's high-risk population; and program components that include case management, disease management and medical necessity.
This enhanced program includes:
- Early identification and referral of enrollees who may benefit from care management
- Local case managers who work only on WSHIP cases
- Support for the chronic care model and medical home concept
- Disease management programs specifically designed to meet the needs of WSHIP's high-risk population
