Health insurance markets in the United States are evolving with an increased emphasis on achieving the Triple Aim of improved patient experience of care, reduced healthcare costs, and improved population health. For health plans, that comes with an increased focus on quality standards and outcomes, and recognition that investment in quality accreditation is becoming essential to business success.
A growing number of state Medicaid contracts are requiring a focus on quality outcomes and quality accreditation by recognized accrediting organizations. One of these organizations, the National Committee for Quality Assurance (NCQA) continues to gain significance as Medicare and Medicaid increase quality requirements tied to NCQA. Regardless of the accrediting organization, achieving accreditation typically requires a significant commitment of time and resources, and follows a similar process.
In this paper, Milliman’s Barbara Culley, Penny Edlund, and Maureen Tressel Lewis provide information about the pursuit of quality accreditation as an essential investment that can have a positive impact on multiple health plan priorities, including quality of care, member satisfaction, and market viability.