NCQA Health Plan Accreditation is the nation’s most trusted independent source for driving health care quality improvement that results in tangible, bottom-line value for health care purchasers. Accreditation enables health plans to distinguish themselves in a highly competitive market by demonstrating their commitment to improving the quality of their health care—and the quality of life for their members.
NCQA began accrediting managed care organizations (MCO) in 1991, in response to a demand for standardized, objective information about performance, and now evaluates all types of health plans (MCO, PPO, POS) using a common set of standards. Today, more than 100 million Americans (70.5% of all health plan members) are covered by an NCQA-Accredited health plan.
NCQA Accreditation is a rigorous, comprehensive and transparent evaluation process through which the quality of the systems, processes and results that define a health plan is assessed—including the care and service that plans deliver in important areas such as diabetes, childhood immunizations and mammograms.
Purchasers, patients, policymakers and health plans consider NCQA Accreditation to be the gold standard for evaluating health care quality and value. NCQA regularly revises and improves its standards to reflect the evolving needs of stakeholders.
NCQA has merged its MCO Accreditation Program and PPO Accreditation Program into a single, consolidated accreditation process using a common set of standards and guidelines: the Health Plan Accreditation Program, which applies to HMO, MCO, POS and PPO plan accreditation.