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  1. Health Systems

    Last modified 04.10.2024
    ncqa.org/health-equity/health-systems/

    Health Systems NCQA programs help health systems identify disparities in care and close gaps for your populations while supporting the priorities of contracting partners.

  2. Health Plans

    Last modified 02.15.2024
    ncqa.org/report-cards/health-plans/

    Health Plan Performance Diverse products and projects share what we learn about health plans.

  3. Population Health Management Prevalidation

    Last modified 12.01.2023
    ncqa.org/programs/data-and-information-technology/hit-and-data-certification/population-health-management-prevalidation/

    NCQA Population Health Management Prevalidation supports four NCQA Accreditation programs: Health Plan, Managed Behavioral Healthcare Organization, Case Management and Population Health. More than 175 million…

  4. Process - UMCR - Other

    Last modified 09.29.2023
    ncqa.org/programs/health-plans/utilization-management/process/

    The Utilization Management Accreditation Process This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation. The typical evaluation time…

  5. Process - CVO - Other

    Last modified 09.29.2023
    ncqa.org/programs/health-plans/credentials-verification-organization-cvo/process/

    Credentials Verification Organization Certification Process This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation.  The typical evaluation time…

  6. Process - WHP - Other

    Last modified 09.29.2023
    ncqa.org/programs/health-plans/wellness-and-health-promotion-whp/process/

    The Wellness and Health Promotion Accreditation/Certification Process This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation.  The typical…

  7. Process - PN

    Last modified 09.29.2023
    ncqa.org/programs/health-plans/provider-network/process/

    The Provider Network Accreditation Process This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation. The typical evaluation time…

  8. Process - MBHO

    Last modified 09.29.2023
    ncqa.org/programs/health-plans/managed-behavioral-healthcare-organizations-mbho/process/

    Managed Behavioral Healthcare Organization Accreditation Process This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation.  The typical evaluation time…

  9. Process - CM

    Last modified 09.29.2023
    ncqa.org/programs/health-plans/case-management-cm/process/

    The Case Management Accreditation Process This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation. The typical evaluation time…

  10. Process

    Last modified 09.29.2023
    ncqa.org/programs/health-plans/population-health-program-accreditation/process/

    Population Health Program Accreditation Process This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation. The typical evaluation time…

  11. NCQA’s Health Plan Ratings 2021

    Last modified 08.18.2023
    ncqa.org/hedis/reports-and-research/ncqas-health-plan-ratings-2021/

    RESOURCES FOR HEALTH PLANS NCQA’s Health Plan Ratings 2021 includes commercial, Medicare and Medicaid health plans. The overall rating is the weighted average of a…

  12. Interactive Review Tool (IRT)

    Last modified 08.04.2023
    ncqa.org/programs/health-plans/interactive-review-tool-irt/

    NCQA video training tutorials help you understand how to use the Interactive Review Tool (IRT) - NCQA’s updated web-based workflow system for managing the end-to-end…