NCQA ACO Accreditation Overview
- Variation in capabilities and readiness make ACOs risky for payers, patients.
- Assures patients their ACOs focus on them and their care
- Aligns purchasers with common expectations
- Identifies which ACOs are likely to be good partners
- A roadmap & vehicle for provider led groups to show their abilities
- For organizations in the formation or transformation stage; have not reached full ACO capability
- Organizations have basic infrastructure and some capabilities outlined in standards.
- Length of status: 2 years
- 50 points
- Must Pass Elements: None
- For well-established organizations that strongly demonstrate the capabilities outlined in the standards
- Length of status: 3 years
- 70 points
- Must Pass Elements: Yes- Report core performance measures and patient experience, evaluate and improve patient-centered primary care, and have complete data on a minimum threshold of patients
- Achieve Level 2 and demonstrate strong performance or improvement across the triple aim
- Length of status: 3 years
- 70 points and performance against triple aim
- Must Pass Elements: Yes: Same as Level 2
- Most ACOs are not ready to be judged mainly on outcomes
- Evidence-based standards can identify which ACOs are most likely to deliver on the triple aim
- Program Operations-The infrastructure to coordinate providers
- Access & Availability- Ensure the ACO has sufficient numbers, types of practitioners, timely access to care, etc.
- Primary Care- Promotes the delivery of patient centered primary care by providing patients access to patient-centered medical homes, etc.
- Care Management- Collects, integrates and uses data from various sources for care management and performance reporting, etc.
- Care Coordination and Transitions- Has a coordinated system to facilitate timely information exchanges between multiple providers
- Patient Rights and Responsibilities- States its commitment to treating patients in a matter that respects their rights and privacy, etc.
- Performance Reporting- Strives to improve the quality of services by evaluating it’s performance using valid measures, make results available to the public and ACO providers
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