NCQA launches ACO accreditation

The National Committee for Quality Assurance (NCQA) will start accountable care organization (ACO) accreditation this month, looking at seven critical areas that, if they pass the smell test, will allow hospitals, physicians, and other providers to qualify for ACOs.

As NCQA notes, not every group of providers that calls itself an ACO actually has what it takes to accomplish an ACO's vital mission, according to a NCQA white paper.

NCQA, the nonprofit organization that accredits and certifies healthcare organizations, including patient-centered medical homes, said its ACO accreditation is an independent evaluation of healthcare delivery organizations' ability to coordinate high-quality, efficient, patient-centered care, according to a press release last week.

Effective Nov. 21, NCQA will look at organizations to assess if they meet the following seven domains: structures and operations, access to needed providers, patient-centered primary care, care management, care coordination and transitions, patient rights and responsibilities, and performance and quality improvement.

"Most ACOs are not ready to be judged mainly on outcomes," according to a NCQA presentation today.

Instead, evidence-based standards will help to identify which ACOs are most likely to deliver on healthcare savings and improved outcomes. NCQA will assign levels of ACO readiness, based on a point system. Level 1 means organizations are in the formation stage and have the basic infrastructure; the status lasts for two years. Level 2 means well-established organizations demonstrate capabilities, a status that lasts for three years. Level 3 means organizations meet level 2 points and demonstrate strong performance or significant improvements, lasting three years and requiring annual reporting and performance evaluation to maintain status.

"NCQA's ACO Accreditation program allows multiple payers to support ACOs and make the ACO concept workable," states the white paper. "We know that organizations that try to be ACOs and manage different parts of their organizations to different sets of goals (e.g., maximizing volume as opposed to striving for efficiency or managing to multiple payers' goals) will run the risk of failing at delivering on the triple aim. ... The ACO standards are designed to optimize the likelihood of success and to reassure consumers that they will not be harmed."

For more information:
- read the NCQA website about the domains
- here's the press release
- read the white paper (.pdf)
- check out the presentation (.pdf)

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