1 Overview of the NCQA Credentialing Standards Presentation for NAMSS Conference By: Veronica C. Locke September 20, 2016 Objectives/Agenda •Review how to read a standard. The programs are: Long-term Services and Supports Distinction and Multicultural Health Distinction. Protect patients’ personal health information. NCQA Case Management Accreditation provides a framework for implementing evidence-based best practices to ensure: Efficient and cost-effective case management processes and service delivery: Manage patients as they move between care settings. Manage valid sample size of individuals for NCQ… Required Standards for NCQA Case-Management Accreditation. Provider-based organizations (e.g., medical groups, hospitals, integrated delivery systems). This … Perform functions covered in the accreditation program or arrange for the functions to be performed, directly or through a service agreement. Copyright © 2020 National Committee for Quality Assurance. More about Accreditation of Case Management for Long-Term Services and Supports (CM-LTSS) programs here. 2. ILS has been NCQA-accredited for Case Management for LTSS since 2017. Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Contractual Services (Quality Solutions Group), Advertising and Marketing Your NCQA Status, Distinction in Multicultural Health Care section. Provide case management services for at least 6 months. 2020 Case Management Standards and Guidelines Effective for surveys with a start date of July 1, 2020 onward. May 15th, 2020. Helps plans measure performance and implement effective improvements to drive better outcomes of care and services for their members. Care Planning. NCQA Accreditation standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement. You will be prompted to log in to your NCQA account. ILS again decided to pursue the prestigious three-year NCQA accreditation in 2020 to align with the company's commitment to enhancing quality of life by improving health outcomes, reducing costs, and addressing social determinants of health. Provide case management services for at least 6 months. Many public health experts are advocating for rapidly scaling up the use of community health workers as part of the COVID response. 4. ILS has been NCQA-accredited for Case Management for LTSS since 2017. Benefits of NCQA Case Management Accreditation . Multicultural Health Care identifies organizations that lead the market in providing culturally and linguistically sensitive services, and working to reduce health care disparities. NCQA offers a Distinction in Multicultural Health Care that identifies organizations—health plans, MCOs, MBHOs, wellness and population health organizations, and others—that lead the market in providing culturally and linguistically sensitive services, and working to reduce health care disparities. Visit the Distinction in Multicultural Health Care section for more information. Knowledge of URAC, NCQA, or CM standards of practice. NCQA Case Management Accreditation addresses delivery of case management services, not just the organization’s internal processes. This virtual seminar provides an in-depth explanation of NCQA's credentialing standards. NCQA is a non-profit organization dedicated to improving health care quality. Manage valid sample size of individuals for NCQA evaluation, where standards require patient file review. Patient monitoring to track care-goal progress. Goal is to provide simple, evidence-informed guardrails for the systems in which community health workers function. Share this page with a friend or colleague by Email. Faculty will also facilitate short activities to … NCQA offers a Long-Term Services and Supports (LTSS) Distinction for organizations who provide case management services and coordinate social services for LTSS. Use patient-centered assessment to determine care needs. NCQA accredits and certifies a wide range of health care organizations, recognizes physicians and physician groups in key clinical areas and manages the evolution of HEDIS, the tool the nation Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. Within six months or less, we will collaborate with your team to create a flexible framework for continuous … NCQA offers a virtual organization renewal survey for some accreditation and certification programs. Long-Term Services and Supports Distinction evaluates NCQA-Accredited case management organizations that coordinate LTSS and want to demonstrate they have the processes to effectively deliver person-centered care. Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Contractual Services (Quality Solutions Group), Advertising and Marketing Your NCQA Status. Introduction to NCQA Credentialing Standards. The standards are designed for organizations providing case management services that include patient identification and assessment, care planning, care monitoring and care transitions to meet the needs of patients and their families; for example: NCQA Case Management Accreditation is for organizations that provide a broad range of case management services for complex and high-risk populations: An organization seeking case management accreditation designates the program it wants evaluated; for example: Find information about NCQA Case Management Accreditation here: NCQA offers several related programs for organizations eligible for the Health Plan Accreditation. 2017 Standards Concepts 21 Care Management and Support Care Coordination and Care Transitions Performance Measurement & Quality Improvement Identifying patients for care management Person-centered care plan development Management of lab/imaging results Tracking and managing patient referrals Care transitions Collecting and analyzing performance data Setting goals Improving practice … 3. 2016 Complete Overview of the NCQA Standards Session Code: TU13 Date: Tuesday, September 20, 2016 Time: 2:30pm - 4:00pm Total CE Credits: 1.5 Presenter(s): Veronica C. 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