NCQA Offers ACO Accreditation Review

For example, ACOs can only be accredited if it has a sufficient number of certain types of providers to serve the population, if it collects and uses data to measure improvement, and if it has a way to protect patient privacy.

Also last November, the NCQA also set forth three levels of accreditation, Level 1 (50 points), Level 2 (70 points plus four "must pass" measures, and Level 3 (all of Level 2, shows improvement and maintains standards for three years).

With the latest announcement this month, the NCQA has identified the specific measures (Healthcare Effectiveness Data Information Set or HEDIS) and other criteria each ACO must meet. For example, practitioners must show that they maintain good blood pressure and cholesterol control for their patients who have cardiovascular disease.

These measures must be demonstrated throughout the provider ACO network, from physician's office to physician's office to clinic to acute care hospital to skilled nursing facility or hospice.