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Call Yourself an ACO? Prove It

Cheryl Clark, for HealthLeaders Media, November 16, 2011

3 levels of accreditation

The NCQA's accreditation program offers three levels, to allow those organizations with varying levels of compliance some framework, based on a scoring system with 100 points.

1. Organizations in the earliest part of their process, for example, those who have not reached full capabilities, might be designated Level 1, in which they would achieve 50 out of 100 points. Certain "must pass" thresholds, such as assuring clinical data and patient information is captured in structured electronic systems with meaningful use, would not be required.

2. Those achieving Level 2 would demonstrate compliance with 70 points and meet four "must pass" measures.

3. Level 3 is reserved for organizations that, in addition to complying with all metrics in Level 2, show significant improvement in measures that assess the triple aim, better quality, better patient experience and lower cost. Level 3, which lasts three years, requires annual performance reporting and evaluation to maintain the status.

Many of the ACOs approved under CMS' various models would not necessarily be accredited under the NCQA's standards, some of which go beyond what CMS requires, Akin-Deko says.

In a fact sheet distributed this week, the NCQA says that "in some communities, health plans are already contracting with integrated delivery systems that they know well. However, we expect that larger plans covering multiple communities, and large employers, will be challenged to understand if organizations are capable of participating in these initiatives."

 


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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1 comments on "Call Yourself an ACO? Prove It"


TumTum (11/16/2011 at 9:42 AM)
We don't need any more certification organizations in healthcare. They just add to costs. Providers don't benefit either. If provider groups want to hire NCQA or Dartmouth or Brookings to ensure that they are prepared to compete in the ACO market, so be it. Perhaps these organizations will also guarantee success as they "certify" - and then it will be a worthwhile investment. But without such success based formulae these certification companies just add to unnecessary overhead.