FAQ Directory: Health Plan Accreditation

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8.24.2018 How does Health Plan Accreditation help my organization?

  • Use the NCQA Health Plan Accreditation standards to perform a gap analysis and determine improvement areas. They provide a framework for implementing evidence-based, best practices help plans improve in areas of:
    • QI process.
    • Population health management.
    • Practitioner network and access to care.
    • Utilization management processes.
    • Credentialing and recredentialing processes.
    • Members’ rights and responsibilities.
    • Member connection.
    • Medicaid service requirements.
  • Satisfy state requirements and employer needs. The standards align with many state requirements.

HP 2020