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Case Management Accreditation

 

NCQA’s Case Management Accreditation is a comprehensive, evidence-based accreditation program dedicated to quality improvement that can be used for case management programs in provider, payer or community-based organizations. Lessons learned from our experience evaluating case management and care coordination in patient-centered primary care settings and population health care organizations are included. NCQA’s Case Management Accreditation is the only program that focuses on ensuring the organization has a process to ensure safe transitions.

NCQA’s Case Management Accreditation:

  • Directly addresses how case management services are delivered, not just the organization’s internal administrative processes.
  • Gets right to the core of care coordination and quality of care.
  • Is designed for a wide variety of organizations. It is appropriate for health plans, providers, population health management organizations, and community-based case management organizations.
  • For organizations that are already accredited, certified or recognized by NCQA, the Case Management Accreditation program completes a commitment to the highest degree of quality improvement. 

     

    What Accreditation Levels Can a CM Organization Achieve? 

    CM organizations can earn the following NCQA Accreditation status levels based on their performance against NCQA’s Standards and Guidelines:  

    Accredited – 3 years: NCQA awards a status of Accredited – 3 years to organizations that demonstrate strong performance of the functions outlined in the standards for CM accreditation. 

    Accredited – 2 years: NCQA awards a status of Accredited – 2 years to organizations that demonstrate performance of the functions outlined in the standards for CM accreditation. 

    Denied: NCQA awards a status of Denied Accreditation to organizations that do not meet NCQA requirements. 

    In-Depth CM Accreditation Information


    New Online Application Process

    A new application and scheduling process begins May 15 for Accrediation programs. Learn more.

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