By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    improving patient experience
    6 Ways to Improve Patient Satisfaction Within Hospitals
    December 1, 2021
    degree for healthcare job
    What Are The Health Benefits Of Having A Degree?
    March 9, 2022
    custom software development is changing healthcare
    Digital Customer Journey Mapping and its Importance for Healthcare
    July 21, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Can Thinking Younger Make You Live Longer?
    April 20, 2011
    Image
    Obesity’s Outlook Unchanged
    June 13, 2011
    When It’s An Emergency Elderly Not Treated As Well in Hospitals
    July 16, 2011
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Is NCQA Accreditation Right for You?
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Finance > Is NCQA Accreditation Right for You?
BusinessFinanceHospital AdministrationPolicy & Law

Is NCQA Accreditation Right for You?

Abby Norman
Last updated: September 16, 2014 8:00 am
Abby Norman
Share
5 Min Read
NCQA Accreditation
SHARE

 

Contents
Who is NCQA?What does NCQA do?Do we need NCQA accreditation?

NCQA Accreditation

In the alphabet soup of healthcare accreditation, chances are there are at least one or two accrediting bodies that you aren’t entirely sure about – one of those might be NCQA. Who are they, what do they accredit and do you need their accreditation in your organization?

 

More Read

My Health Plan Made Me Laugh
Consumer Genomic Testing Challenges Physicians to Stay Within the Guidelines
Community Hospitals Shouldn’t Complain About Steward
Employers Opt for Medical Tourism
Why 2014 Should Be a Good Year for Consumer and Enterprise Health IT

NCQA Accreditation

In the alphabet soup of healthcare accreditation, chances are there are at least one or two accrediting bodies that you aren’t entirely sure about – one of those might be NCQA. Who are they, what do they accredit and do you need their accreditation in your organization?

Who is NCQA?

The National Committee for Quality Assurance is an independent, non-profit in the United States that is concerned with establishing quality standards for healthcare organizations that aim to identify key areas of improvement within the organizations themselves. NCQA was established in the early ‘90s, a time in United States healthcare where there was a discernible shift in healthcare reform throughout The Clinton Administration.

What does NCQA do?

The NCQA’s programs are voluntary for organizations, physician practices and individual physicians – though, their stamp of approval is widely regarded as a longstanding measure of quality improvement and speaks to an organization’s ongoing quality initiatives. They also review health plans, and in a competitive healthcare marketplace, it certainly doesn’t hurt to have accreditation if you want to do business. NCQA review is a rigorous process, one that requires planning, dedication and even a bit of elbow grease. Knowing that it is both an economic investment and an investment of time and energy for staff, how can your organization decide if you should undertake NCQA accreditation?

Do we need NCQA accreditation?

For health plans, anyway, NCQA is the gold standard. Their review will evaluate the plan’s ability to meet employer demands, industry demands and, arguably most important, consumer demands. Especially now that consumers are ‘shopping around’ for health insurance coverage, it’s never been a more competitive market for insurers to try to survive in. Federal plans, like Medicare, insist upon the accreditation and forty states in the union recognize the accreditation; several dozen mandate it.

NCQA manages several key areas of performance, whether they are evaluating an organization, a group of physicians or a health plan:

  • Health promotion. Do the activities of the health plan or organization promote preventative care, work hard to ensure the return to health of its beneficiaries and is the goal to help patients avoid illness?
  • Recovery. Even the best preventative care is unlikely to keep everyone healthy at all times; so, when patients are sick, does the organization or plan work hard to get patients back on their feet? How do they evaluate and support new treatments and technologies? Are patients being offered the most up-to-date care – or are they getting left behind?
  • Chronic Illness. For patients with chronic illnesses, does the organization or plan develop proven, long-term strategies for management of these conditions? Do patients have access to resources in their communities?
  • Access. Are there enough doctors to meet demands of the community? If patients report not having access to the care they need, how are these reports handled? What is done to remedy this situation?
  • Qualification. Are the doctors serving the institution the highest qualified and working “to the top of their licensure?” Are physicians and other medical staff routinely evaluated and their credentials checked? Are they required to complete continuing education to further their expertise and experience to assimilate new information and technologies in the rapidly evolving field of medicine?

For Accountable Care Organizations, NCQA accreditation only stands to further prove your organization’s intent to commit to quality improvement initiatives, ongoing staff education and your accountability to patients in your community. These are noble values for any business – but especially in healthcare where it’s no longer enough for a hospital and its providers to be “good” – you’ve got to be great if you want to compete.

Share This Article
Facebook Copy Link Print
Share
By Abby Norman
My name is Abby Norman and I am a healthcare blogger. With over 10 years of experience in the medical field, I have developed a passion for helping others understand the complexities of healthcare.

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025
Learn how to Renew your Medical Card in West Virginia
Learn how to Renew your Medical Card in West Virginia
Health
May 15, 2025
Dr. Klaus Rentrop Shares Acute Myocardial Infarction heart treatment
Dr. Klaus Rentrop Shares Acute Myocardial Infarction
Cardiology
May 13, 2025

You Might also Like

If Airlines Were Run Like Healthcare – Video

July 10, 2011
Public HealthWellness

Conceiving Past 30: What Women Need To Know

July 25, 2019

Medicaid Expansion: Poor States Are Subsidizing Rich Ones

September 6, 2014
doctor hipaa compliant on social media
Policy & LawSocial Media

How to Stay HIPAA Compliant When Using Social Media for Healthcare

April 21, 2016
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?