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NCQA Lends Quality Improvement Expertise to Long-Term Services and Support


Seeks Feedback on Proposed Accreditation Standards February 24–March 23

WASHINGTON, DC— Building upon 25 years of experience promoting quality improvement in health care, the National Committee for Quality Assurance (NCQA) now intends to expand its evaluation efforts to include organizations responsible for the coordination of long-term services and supports (LTSS). NCQA staff spent months consulting with LTSS providers, consumer advocates, payers and policy experts to draft proposed standards for accreditation. 

The proposed LTSS updates apply to two existing accreditation products: Health Plan Accreditation (HPA 2017) and Managed Behavioral Healthcare Organization Accreditation (MBHO 2017). Those standards would be effective in July of 2017. Additional standards have been drafted for a new product, Case Management for Individuals Receiving LTSS (CM-LTSS). Those Standards would be effective upon release in July 2016. 

The proposed standards will improve care for individuals who need LTSS by requiring organizations to: 

  • Institute person-centered care planning. The individual using care and services controls activities surrounding care planning. 
  • Manage care transitions. Organizations have a process to effectively manage transitions, support individuals during transitions and reduce unplanned transitions. 
  • Use a critical incident management system. Organizations have a dedicated system to promptly report, track and follow-up on incidents such as abuse, neglect, and exploitation. • Coordinate services. Care and services are coordinated for individuals who have complex needs and multiple providers, and care gaps are closed. 
  • Set qualifications for providers. Organizations set and verify qualifications and provide training and support to home- and community-based service providers.  

How to Participate in Public Comment 

NCQA encourages members of the public including state Medicaid programs, health plans, community-based organizations, current case management customers and other stakeholders to provide feedback. 

Read and comment on the proposed changes online. The Public Comment period begins at 9 a.m. ET on February 24 and ends at 5 p.m. ET on March 23, 2016.

Media Contacts

Matt Brock
202-955-1739

Cindy Peña
202-735-3690