Health Plan Accreditation

Health plans must support care that keeps members at optimum levels of health while also controlling costs and meeting government and purchaser requirements. NCQA Health Plan Accreditation helps plans meet these goals.

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Latest Health Plan Accreditation Blog Articles

RELATED PROGRAMS

NCQA offers several related programs for organizations eligible for Health Plan Accreditation. Each program helps organizations improve their operations and initiatives in targeted areas and demonstrate their commitment to quality.

Medicare Advantage Deeming

Health Plans that earn NCQA Medicare Advantage deeming are deemed for Medicare requirements for Special Needs Plan Model of Care requirements.
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Long-Term Services and Supports Distinction

NCQA offers a Long-Term Services and Supports (LTSS) Distinction for organizations that provide managed health services and coordinate social services for LTSS.

The standards provide a framework for organizations to deliver effective person-centered care that meets people’s needs and aligns with state requirements.
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Health Equity Accreditation Programs

Health Equity Accreditation Programs focus on the foundation of health equity work: building an internal culture that supports the organization’s external health equity work; collecting data that help the organization create and offer language services and provider networks mindful of individuals’ cultural and linguistic needs; identifying opportunities to reduce health inequities and improve care.

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Health Plan Medicaid Module

The Health Plan Medicaid Module helps plans improve their opportunity to receive a streamlined state annual compliance review.
Learn more.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

CAHPS® is a registered trademark of the Agency for Healthcare Quality and Research (AHRQ).

Coronavirus and Health Plan Accreditation

See the available telehealth accommodations and exceptions for NCQA Accreditation and Certification programs.

We are adapting policies in response to the COVID-19 pandemic. Learn more here.