- 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.
This applies to the following Programs and Years:
HP 2017, 2018, 2019, 2020
