Health Plan Accreditation
NewHealthPlan_Accreditated_RGB_lowres.jpgNCQA Health Plan Accreditation is designed to help employers and consumers distinguish between health plans based on quality. Among the changes for Accreditation 2008 is the alignment of accreditation standards for managed care organizations (MCO) and preferred provider organizations (PPO) into a unified set of standards for all health plans.

Health Plan Accreditation evaluates not only the core systems and process that make up a health plan, but the actual results that the plan achieves on key dimensions of care and service, as well. The review process is rigorous, consisting of onsite and offsite evaluations conducted by survey teams of physicians and managed care experts. The Review Oversight Committee (ROC), a national oversight committee of physicians, analyzes the  teams' findings and assigns an accreditation status based on a plan's compliance with NCQA standards and its performance, relative to other plans, on selected HEDIS performance measures, such as immunization and mammography rates and member satisfaction.

Developed with the input and support of employers, unions, health plans and consumers, NCQA requirements are demanding. NCQA purposely sets the standards high to encourage health plans to continuously enhance quality.

Other Health Plan Related Programs

Questions?

For more information, please e-mail customersupport@ncqa.org or call (888) 275-7585, M-F, 8:30 a.m. – 5:30 p.m. ET.



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