New Health Plan (NHP) Accreditation

NOTE: 2012 NHP will not be effective after June 30, 2013. If you are a health plan wishing to qualify for health insurance marketplaces, you will be using the
2013 Health Plan Accreditation products.

NCQA’s New Health Plan (NHP) Accreditation Program is available to health plans that are less than three years old. It evaluates how well a plan manages its clinical and administrative systems to deliver value to purchasers and improve health care for its members.

NHP accreditation involves onsite and offsite evaluations, conducted by a survey team of physicians and health plan experts. NCQA’s Review Oversight Committee (ROC) analyzes the team's findings and assigns an accreditation level based on the plan’s performance against standards for improving health care access and services and practitioner credentialing. Comparisons between NCQA-Accredited plans and nonaccredited plans demonstrate that accredited plans deliver greater value through improved quality.

Market Your Quality

NHP Report Card

View the New Health Plan Accreditation Report Card.

NCQA Policy Support

Frequently Asked Questions (FAQs)
FAQs about Accreditation, Certification and HEDIS. Updated the 15th of every month.

Policy Updates & Supporting Documents
News about Accreditation, Certification and HEDIS measures.

Policy Clarification Support (PCS)
Can't find what you need in FAQs or Policy Updates? Submit your question here.