Get Started – Health Plan Accreditation

Health plans must support care that keeps members at their optimum level of health while also keeping costs down and meeting government and purchaser requirements. That’s no small task. NCQA Health Plan Accreditation helps plans meet these goals. The program builds upon more than 25 years of experience to provide a current, rigorous and comprehensive framework for essential quality improvement and measurement. And, is the only program that bases results on actual measurement of clinical performance (i.e., HEDIS®) and consumer experience (i.e., CAHPS®).

HOW DOES MY ORGANIZATION BENEFIT?

• Use the NCQA Health Plan Accreditation standards to perform a gap analysis and determine improvement areas. They provide a framework for implementing evidence-based, best practices to help plans improve in areas of:
  • QI process.
  • Population health management.
  • Practitioner network and access to care.
  • Utilization management processes.
  • Credentialing and recredentialing processes.
  • Members’ rights and responsibilities.
  • Member connection.
  • Medicaid service requirements.
• Satisfy state requirements and employer needs. The standards align with many state requirements.
• Keep patients happy and healthy. The standards provide a framework for improving key impact areas.
• Demonstrate your commitment to quality.

Learn more today. Fill out the form to the right to receive more information about this program or to speak to an NCQA program expert.