Protect patients’ personal health information. We do not share your information with third parties. by NCQA; HEDIS was initiated as a national cooperative project between several health plans and leading employers such as GTE, Digital and Xerox with the goal being to create a standard set of health plan quality indicators, covering preventive care processes and outcomes, with NCQA Case Management Accreditation addresses delivery of case management services, not just the organization’s internal processes. Manage valid sample size of individuals for NCQA evaluation, where standards require patient file review. Please see the … Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. Requirements cover these key areas: To see all program requirements, get the Standards & Guidelines document. May 15th, 2020. 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. This OnDemand event provides a focused and thorough examination of the HPA Standards for Population Health Management (PHM). This Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. Use accreditation status to reflect implementation of evidence-based standards for care and your program’s commitment to ongoing quality improvement. Use patient-centered assessment to determine care needs. 4. Maintenance of Continuing Education appropriate to care management and renewal of any certifications Demonstrated accountability and skills in analysis, decision making, time management and oral, written communication Familiarity with available resources that include any applicable regulations, reimbursement guidelines, community … Deliver a broad range of case management services for complex or high-risk populations. 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 Organizations must meet program criteria to pursue the accreditation. Use patient-centered assessment to determine care needs. Press release. Care Management; NCQA Panel to Create Standards for Community Health Worker Profession. Many payers across the country plan to pay practices a bonus for meeting NCQA standards. Patient monitoring to track care-goal progress. It’s important for organizations to coordinate services effectively among caregivers, individuals, LTSS providers and clinicians. NCQA offers a virtual organization renewal survey for some accreditation and certification programs. 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. Locke, MHSA . As the population ages, more states are seeking to increase accountability, improve quality and promote a cost-effective service delivery system that integrates care across all services—medical, behavioral, social and LTSS. “Case Management Accreditation moves us closer to measuring quality across population health management initiatives,” said Margaret E. O’Kane, President, NCQA. Set your organization apart … NCQA offers a Long-Term Services and Supports (LTSS) Distinction for organizations who provide case management services and coordinate social services for LTSS. David Raths . You will be prompted to log in to your NCQA account. Uses up-to-date evidence-based information to develop its case-management program, and regularly updates the program with relevant findings and information. Helps plans measure performance and implement effective improvements to drive better outcomes of care and services for their members. What is population health management? Deliver a broad range of case management services for complex or high-risk populations. Population health management organizations. NCQA Case Management Accreditation evaluates organizations performing case management services that typically focus on patients who are at high risk of experiencing costly hospitalizations or poor health outcomes because of complex social, behavioral or medical needs. LTSS Distinction can support your organization in achieving these goals. Develop personalized, patient-centered care plans. Multicultural Health Care identifies organizations that lead the market in providing culturally and linguistically sensitive services, and working to reduce health care disparities. Use evidence-based standards to perform a gap analysis and determine improvement areas: Demonstrate the quality of your organization’s programs. Required Standards for NCQA Case-Management Accreditation. Case Management Accreditation Requirements. Within six months or less, we will collaborate with your team to create a flexible framework for continuous … NCQA Accreditation standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement. Explaining HPA Standards for Utilization Management (UM) OnDemand . Faculty will also facilitate short activities to … Copyright © 2020 National Committee for Quality Assurance. Use accreditation standards to align goals and approaches to case management across payers and providers. NCQA Case Management Accreditation requirements ensure that organizations can consistently use efficient and cost-effective case management processes and delivery of services. On July 15, 2020, NCQA awarded Western Reserve Area Agency on Aging Accreditation of Case Management for Long-term Services and Supports (LTSS) for 3 years. Explaining HPA Standards for Delegation (DEL) OnDemand. Part 1 will take place on May 26, 2020, 12:30pm-4:30pm (EST). NCQA Case Management Accreditation evaluates organizations performing case management services that typically focus on patients who are at high risk of experiencing costly hospitalizations or poor health outcomes because of complex social, behavioral or medical needs. Faculty will walk participants through a detailed explanation of each Credentialing standard and lead participants through scenarios that are designed to mimic real-life credentialing scenarios. 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 The programs are: Long-term Services and Supports Distinction and Multicultural Health Distinction. Provide case management services for at least 6 months. ILS again decided to pursue the prestigious three-year NCQA accreditation in 2020 to … This virtual seminar provides an in-depth explanation of NCQA's credentialing standards. Join the LTSS Best Practices Academy here. Explaining NCQA Health Plan Accreditation (HPA) Series. Standards help plans in: Quality Management and Improvement. This accreditation helps support organizations that coordinate LTSS by … Visit the LTSS Distinction section for more 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. Copyright © 2020 National Committee for Quality Assurance. Patient Identification and Assessment. It’s a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet comprehensive medical, behavioral and social needs of patients and their families while promoting quality, cost-effective outcomes. Systematically identifies patients who qualify for its programs. 2 Scoring Level of performance necessary to receive specified percentage of points Data source Documentation organizations use to demonstrate … Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. Share this page with a friend or colleague by Email. To receive this award, WRAAA was required to demonstrate strong performance of the functions outlined in the NCQA Standards for Accreditation of Case Management for LTSS. URAC’s Case Management accreditation standards require companies to establish the policies, procedures and structure needed for optimal performance across four main principles of case management: care coordination, transitions of care, patient engagement and advocacy. Of evidence-based standards for Population Health Management ( UM ) through a service.. Ncqa offers a virtual organization renewal survey for some Accreditation and Certification.... For California Department of Health care disparities and improvement a Long-Term services and Supports ( CM-LTSS ) programs here evidence-based! Organizations who provide case Management processes and delivery of services three-year NCQA Accreditation in 2020 …. 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