Case Management Accreditation
NCQA’s Case Management Accreditation is a comprehensive, evidence-based accreditation program dedicated to quality improvement that can be used for case management programs in provider, payer or community-based organizations. Lessons learned from our experience evaluating case management and care coordination in patient-centered primary care settings and population health care organizations are included. NCQA’s Case Management Accreditation is the only program that focuses on ensuring the organization has a process to ensure safe transitions.
NCQA’s Case Management Accreditation:
Directly addresses how case management services are delivered, not just the organization’s internal administrative processes.
Gets right to the core of care coordination and quality of care.
Is designed for a wide variety of organizations. It is appropriate for health plans, providers, population health management organizations, and community-based case management organizations.
For organizations that are already accredited, certified or recognized by NCQA, the Case Management Accreditation program completes a commitment to the highest degree of quality improvement.
What Accreditation Levels Can a CM Organization Achieve?
CM organizations can earn the following NCQA Accreditation status levels based on their performance against NCQA’s Standards and Guidelines:
Accredited – 3 years: NCQA awards a status of Accredited – 3 years to organizations that demonstrate strong performance of the functions outlined in the standards for CM accreditation.
Accredited – 2 years: NCQA awards a status of Accredited – 2 years to organizations that demonstrate performance of the functions outlined in the standards for CM accreditation.
Denied: NCQA awards a status of Denied Accreditation to organizations that do not meet NCQA requirements.
In-Depth CM Accreditation Information