FAQ Directory: Case Management

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8.24.2018 Are there additional resources for case management organizations seeking LTSS Distinction?

  • LTSS Best Practices Academy: Interactive forum for professionals to discuss strategies for coordinating quality long-term services and supports (LTSS) programs.
  • LTSS Roadmap: A compilation of resources to guide organizations through meeting Case Management and Health Plan Standards for LTSS.

CM 2017

8.24.2018 What is the price for the LTSS Distinction for Case Management Organizations?

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

CM 2017

8.24.2018 Where can I find information to help me get started with LTSS Distinction for Case Management Organizations?

8.24.2018 How does this LTSS Distinction help my case management organization?

Earning NCQA Accreditation of Case Management for LTSS can help organizations:

  • Become more efficient. A focus on coordinated care, training and measurement can help organizations reduce errors and duplicated services.
  • Integrate care better. Standards can help organizations improve communication between individuals, caregivers, providers, payers and other organizations that coordinate care.
  • Provide person-centered care. Standards focus on person-centered services, which can lead to better care planning and monitoring.
  • Support contracting needs. Standards align with the state needs. NCQA-Accredited organizations demonstrate that they’re ready to be trusted partners in coordinating LTSS services.

CM 2017

8.20.2018 Where can I find information to help me get started?

8.20.2018 How does Case Management Accreditation help my organization?

Use the NCQA Case Management Accreditation standards to perform a gap analysis and determine improvement areas. They provide a framework for implementing evidence-based best practices to ensure:

  • Efficient and cost-effective case management processes and service delivery.
  • Apply a QI process to improve operations.
  • Maintain security of personal health information.
  • Ensure patient access to well-qualified case management staff.
  • Develop personalized, patient-centered care plans.
  • Manage patients between care settings.
  • Conduct systematic patient-centered assessments.
  • Monitor patient to care goals progress.

CM 2013

8.20.2018 How long does it take to earn Case Management Accreditation?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

CM 2014

8.20.2018 How do I get started?

If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.

CM 2014

8.20.2018 What is the process for earning Case Management Accreditation?

The first step to earning accreditation is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.

Align your organization’s processes with the standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review.

See a step-by-step process.

CM 2014

8.20.2018 What organizations are eligible for Case Management Accreditation?

Case Management Accreditation is for organizations that provide a broad range of case management services for complex and high-risk populations. Organizations are eligible if it:

  • Provides case management services for at least 6 months.
  • Delivers a broad range of case management services for complex or high-risk populations.
  • Perform functions covered in the accreditation program or arrange for the functions to be performed, directly or through a service agreement.

Manage valid sample size of individuals for NCQA evaluation, where standards require patient file review.

CM 2014

8.20.2018 What is Case Management Accreditation?

NCQA Case Management Accreditation is a comprehensive, evidence-based program dedicated to quality improvement that evaluates the operations of case management programs in provider, payer or community-based organizations. NCQA-Accredited organizations demonstrate they have the internal processes and service delivery structure to cost-effectively meet the complex patient needs to improve health or functional capability.

CM 2013

8.20.2018 Where can I find the Case Management Standards and Guidelines?