NCQA Offers ACO Accreditation Review

The NCQA, which also has set quality criteria for accreditation of medical homes, health insurance plans, employer wellness programs, multicultural health initiatives, and many other improvement efforts, has established dozens of specific criteria these ACOs must demonstrate.

For example, there are key measures providers must meet to demonstrate high quality in childhood disease and obesity prevention. They also must show that they meet certain processes of care expected for patients with cardiovascular, respiratory, blood glucose, musculoskeletal, and behavioral health issues.

The NCQA also has established criteria for competency in medication management, access and availability, utilization, and especially care coordination, so that physicians and hospitals make sure patients get what they need after they leave an acute care or clinic setting.

Other measures cover cancer screening, prescription drug use, and immunizations.

Last November, the NCQA announced its ACO accreditation program, and identified the basic competencies these groups are expected to have, or the structure of the ACO accreditation program.