A Unique Way to Achieve the Triple Aim

March 18, 2015 · NCQA

Caregiver Homes—the first home and community based services (HCBS) organization to receive NCQA’s Case Management Accreditation—provides training and support for people caring for loved ones. NCQA recently spoke with Caregiver about what other organizations can learn from its model of care.

What makes you different from other organizations?

We provide an alternative care environment for complex elders and consumers with disabilities, by paying a family caregiver to provide live-in support for their loved one. We assign a clinical team to interact with the caregiver through home visits, phone calls or online communication. Our model offers a tremendous boost to the quality of life and care, better overall satisfaction for the patient and invaluable emotional, economic and professional support to the caregiver.

What interested you in accreditation?

Accreditation is essential to our growth and shows that we are both pioneers and partners in quality. States are shifting risk for long-term care to managed care, and health plans are more inclined to partner with organizations that are similarly minded about quality.

What surprised you during the accreditation process?

We worried that our model would be a large departure from traditional models and provider types that NCQA accredits, but learned that NCQA was open to seeing how we approached case management. We were grateful for NCQA’s “one-size-doesn’t-fit-all” approach to our review process.

What advice do you have for other organizations that have a unique care model and are interested in NCQA Case Management Accreditation?

Our advice to others is, “Don’t fear NCQA’s standards!” Take a thoughtful, introspective look at the operations and quality improvement programs in place and evaluate how you use your data, metrics and analytics. Formalizing these areas takes discipline and dedicated resources and ultimately proves worthwhile.

What can other NCQA-Accredited organizations learn from you?

Individuals with complex conditions need unique case management services to help them maintain their independence in the community. Since their needs vary, standard approaches of engagement may not achieve the Triple Aim (improving population’s experience of care and health, reducing health care costs.) The well-being and support of the caregiver cannot be ignored. At Caregiver Homes, we are caring for both consumer and caregiver, engaging each as an individual contributor to a successful care plan.

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