July 30, 2023
WASHINGTON, DC—July 31, 2023—The National Committee for Quality Assurance (NCQA) today announced new features for its Long-Term Services and Supports (LTSS) Distinction and the Accreditation of Case Management for LTSS programs. The program enhancements and new standards help organizations managing long-term care deliver high-quality, equitable care that aligns with state requirements and meets the evolving needs of their communities.
“NCQA’s Accreditation of Case Management for LTSS and LTSS Distinction in Health Plan Accreditation have been the industry standard for organizations administering LTSS since we launched the programs in 2016,” said NCQA President Margaret E. O’Kane. “Today the population is aging, and states are looking to increase accountability, improve quality and promote cost-effective delivery of long-term care services outside the traditional hospital setting. It’s time to update our standards to reflect and support health care organizations eager to provide equitable, high-quality care to people in the environment that is best for them.”
Case Management-LTSS Accreditation
NCQA CM-LTSS Accreditation is designed for organizations that coordinate LTSS for populations with complex needs. Long-term care organizations need assurance that their partners can coordinate care effectively across medical, behavioral and social services and help keep people in their preferred setting—often, their home.
Enhancements include scoring aligned with NCQA Health Plan Accreditation, the creation of an interim survey to provide a guide path for community-based organizations to earn accreditation followed by a full survey, as well as updates to care assessment, clinical integration and coordination. These enhancements support the identification of sub-populations to inform how programs are structured to meet varied needs, new health equity standards and data collection, standardized person-centered goals and recognition for high achievement.
Earning NCQA accreditation of CM- LTSS can help organizations become more efficient and focus on coordinated care, training and measurement to reduce errors and duplicated services. Additionally, the standards can help improve communication between stakeholders that coordinate care, focus on person-centered services which lead to better care planning and monitoring and support contracting needs to align with state needs.
LTSS Distinction
NCQA LTSS Distinction provides a person-centered, comprehensive and standardized evaluation of organizations delivering managed long-term services and supports. LTSS Distinction is designed for organizations that manage both medical care and LTSS for their members. Earning LTSS Distinction can help organizations improve operational efficiencies and improve care communication between individuals, caregivers, providers and payers while reducing errors and duplicated services.
Enhancements include scoring aligned with Health Plan Accreditation standards, the creation of an interim survey to provide a glide path for community-based organizations to earn accreditation followed by a full survey, as well as updates to the care assessment, standardized person-centered goals, and new requirements for health equity, data collection, and recognition for clinical integration and coordination. These enhancements inform how programs are structured to meet varied LTSS population needs and meet or exceed state requirements.
About NCQA
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA Accredits and Certifies a wide range of health care organizations. It also Recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. The organization received the prestigious James W. Rouse Excellence in Diversity Award for demonstrating a commitment to promoting a diverse, healthy workplace. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make informed health care choices. NCQA can also be found at Twitter @ncqa, and on LinkedIn at linkedin.com/company/ncqa.
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Media Contact
Theresa Masnik
SHIFT Communications