4 out of 5 Exchange Health Plans Hold NCQA Accreditation

4 out of 5 Exchange Health Plans Hold NCQA Accreditation

Almost 85 percent of the health plans offered in the Exchange Marketplaces launching October 1 are accredited by the National Committee for Quality Assurance (NCQA), a strong presence confirming NCQA’s role as a leader in health care quality.

“The overwhelming preference for NCQA Accreditation is a gratifying reminder that NCQA is the gold standard in health care quality,” said NCQA President Margaret E. O’Kane. “The pervasiveness of NCQA Accreditation on Day 1 of the Exchange era means millions of previously uninsured people will have access to high-quality care.”

NCQA Accreditation will be as useful as it is ubiquitous in Exchange marketplaces. NCQA accredits health plans with strong consumer protections, and the NCQA seal means a plan has passed a rigorous review of its quality operations. This includes assessing whether the plan has strong processes for care coordination, verifies providers’ credentials and effectively informs enrollees about providers in the network.

NCQA is also the only health plan accreditor that publicly reports detailed quality results, .

Nearly 60 health plans that previously held no accreditation chose NCQA Accreditation in order to qualify for Exchanges by October 1. That surge in health plan customers is one of the largest in NCQA’s 23-year history. Hundreds of other plans that already held NCQA Accreditation have also modified their accreditation to participate in Exchange marketplaces.

Accreditation by an approved, national reviewer is an important prerequisite to Exchange participation required in the Affordable Care Act. As detailed in formal rulemaking, the requirement has been implemented in the early years of the Exchange, but also allowed plans time to prepare and pursue accreditation.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers, and researchers.

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.