Health Outcomes Accreditation + Community-Focused Care Accreditation FAQs

About NCQA Accreditation Programs

NCQA’s programs are developed and updated in collaboration with subject matter experts, health care organizations, health care consumers and their advocates, community-based organizations and state partners. Accreditations in Health Outcomes and Community-Focused Care were developed under the guidance of cross-sector expert advisory panels in 2009 and 2021. Subsequent program updates have been guided by extensive literature reviews, qualitative interviews and public comments to ensure that programs reflect current evidence and industry needs.

What is Health Outcomes Accreditation?

NCQA’s Health Outcomes Accreditation program helps health care organizations identify and address barriers that prevent their members/patients from accessing high-quality care.

What is Community-Focused Care Accreditation?

NCQA’s Community-Focused Care Accreditation program helps health care organizations cultivate community-based partnerships to connect members/patients to non-medical or social needs resources.

How are these Accreditations related to Health Equity Accreditation/Plus?

Health Outcomes Accreditation is a standalone program that evolved from NCQA’s Multicultural Health Care Distinction and the Office of Minority Health’s national CLAS Standards. Community-Focused Care Accreditation is a standalone program developed in collaboration with health care and community-based stakeholders to acknowledge the unique role of non-medical or social needs—and community health—on population health outcomes.

Do I need another NCQA Accreditation to earn Health Outcomes or Community-Focused Care Accreditation?

No. You can earn both independent of other NCQA programs.

Do I need to earn one Accreditation before the other?

No. You can pursue either or both programs independently, in any order.

What organizations are eligible to earn these Accreditations?

Health plans, health systems, hospitals, clinics, FQHCs, practices, specialty benefits administrators, MBHOs and organizations that provide population health, wellness, case management or medication management services—and more—are eligible.

Where can I find the standards and guidelines?

Standards and guidelines are available in the NCQA Store as part of the Survey Readiness Package for Accreditations in Health Outcomes and Community-Focused Care.

How do we earn Accreditation?

1. Download the free program toolkit for information about program requirements and the NCQA survey process.
2. Discuss the Accreditations with an NCQA program expert. Request a meeting by completing this form.
3. Purchase the Survey Readiness Package for Accreditations in Health Outcomes and Community-Focused Care for access to the standards and guidelines, in-depth program educational resources, a gap analysis tool and live town halls with NCQA program experts.
4. Conduct a gap analysis to evaluate your organization’s compliance with program requirements and identify when you’ll be ready for survey.
5. Ask questions! As you review the standards and guidelines, submit questions to NCQA program experts through My NCQA.
6. Submit a pre-application form to the NCQA program expert you met in step 2.
7. Submit an online application. An NCQA representative will walk you through the process.
8. Purchase the survey tool to begin preparing evidence for your upcoming survey.
9. Implement new processes, and update policies, processes, reporting or system capabilities to align with program requirements—plan to be fully compliant with requirements at least 6 months before your scheduled survey date.
10. Submit your survey tool on your survey submission date.
11. NCQA reviews your submission and issues a status determination within 90 days.

Read more about the survey process here.

How long does it take to earn Accreditation?

Plan a survey submission date 12–15 months from the time of your application, although your readiness depends on gaps that were surfaced during your gap analysis. Organizations already working within or close to NCQA guidelines may require a shorter preparation time frame.

How do we start?

If you aren’t currently Accredited and want to learn more, contact NCQA. Download the program’s free program toolkit for information about program requirements and the NCQA survey process. If you have current Accreditation and want to talk to someone about your status, renewal or adding Accreditations, submit a question through My NCQA.

Where can I find information?

Free program toolkit. Overview of program requirements and the NCQA survey process. Accreditation Process and Timeline. Key steps, timing and resources for a successful Accreditation journey. Survey Readiness Package. Access to the complete standards and guidelines, gap analysis tool, program educational courses and live town halls with NCQA program experts. Interactive Survey Tool (IRT). The complete standards and guidelines. You can also self-score your organization’s survey readiness—the tool calculates your potential survey score.

Which organizations have earned NCQA Accreditation?

You can find a directory of Accredited organizations on the NCQA Report Cards.