NCQA Releases ACO Accreditation Program Standards

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The National Committee for Quality Assurance (NCQA) today released the standards and guidelines that form the basis of its ACO accreditation program.

Developed over two years with assistance from a task force of health care industry stakeholders, the standards require ACOs to demonstrate capabilities in seven key areas: program operations, access/availability, primary care, care management, care coordination/transitions, patient rights/responsibilities, and performance reporting

“Accreditation identifies which ACOs are likely to be good partners” and serves as “a roadmap and vehicle for provider-led groups to show their abilities,” the NCQA noted in briefing materials released to the media.

Accreditation is awarded on three levels. Organizations designated as Level 1 are in the formative or transformative stage of moving into an ACO model and meet some standards, but cannot yet be considered fully capable ACOs. Reflecting the expectation that these designees will be re-quickly revaluated for strengthened capabilities, Level 1 status lasts for two years.

Level 2 ACOs have been pegged as having the best chance of achieving “triple aim”—i.e., strong performance or significant improvement in core performance measures of clinical quality, patient experience, and efficiency/utilization. This designation lasts for three years,

Meanwhile, Level 3 designation is reserved for organizations that have achieved Level 2 status and demonstrate strong performance or marked improvement in measures across the “triple aim”.

Entities eligible for the NCQA’s ACO accreditation program include providers in group practices, networks of individual practices, hospital/provider partnerships, hospitals and their employed or contracted providers, publicly governed entities that work with providers to arrange care, and provider/health plan partnerships.

To read the press release, click here: http://www.ncqa.org/tabid/1450/Default.aspx