NCQA Health Plan Accreditation is the Gold Standard for assuring and improving quality care and patient experience.  It reflects a commitment to quality that yields tangible, bottom-line value. It also ensures essential consumer protections, from fair marketing to sound coverage decisions, access to care, timely appeals and more.

NCQA’s is the most rigorous, comprehensive and transparent accreditation program. It includes unbiased, third party review to verify, score and publicly report results. This lets consumers and other purchasers make apples-to-apples comparisons among plans.

NCQA regularly revises and updates our standards to reflect clinical advances and evolving stakeholder needs. This raises the bar, moves the market towards best practices, and leads to continuous improvement and better value.

Many purchasers and regulators rely on NCQA Accreditation to get the best value. For example:

• NCQA Accreditation is closely aligned with eValue8 – a national system for evaluating health plan performance used by many employers and benefits consultants.
   
• NCQA Accreditation closely aligns with State Health Insurance Exchange plan requirements. These include access to care, utilization management, quality assurance, provider credentialing, complaints and appeals, network adequacy and access, patient information programs, and evaluation on clinical and patient experience measures. We will further align with final Exchange rules that are still to come.
   
• Medicare deems many NCQA elements as satisfying Medicare Advantage plan requirements.
   
• The majority of state Medicaid agencies require or recognize NCQA accreditation.
   

NCQA began accrediting health plans in 1991 to meet increasing demand for objective, standardized plan performance information. Our rigorous standards apply to all types of health plans, including HMOs, PPO and POS. plans. And NCQA-Accredited health plans now cover more than 107 million Americans.