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²»Á¼Ñо¿Ëù’s NCQA Health Plan Accreditations

The National Committee for Quality Assurance (NCQA) helps improve health care quality. NCQA evaluates health plans in meeting standards and guidelines through an accreditation process which evaluates operational policies, data used to monitor operations, care and services outcomes, implementation of quality improvement process, and verification of processes related to health care management.

²»Á¼Ñо¿Ëù Corporation's health plans have several NCQA accreditations and distinctions:

• Health Plan Accreditation (HPA)Ìýmeasures health plan performance related to quality improvement, population health, network management, utilization management, credentialing, and member experience.
• Health Outcomes Accreditation (HOA)Ìýprovides a data-driven understanding of the health plan’s population and their unique needs and experiences, identifying and addressing gaps and disparities in care.
• Community-Focused Care Accreditation (CFCA)Ìýassists health plans to cultivate community-based partnerships to connect members to non-medical or social needs resources.
• Long-Term Services & Supports (LTSS)ÌýDistinction provides a framework for organizations to deliver person-centered care that meets individual’s needs and state requirements.

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²»Á¼Ñо¿Ëù’s Specialty Healthcare Organization NCQA and URAC Accreditations

NCQA

National Committee for Quality Assurance evaluates specialty programs for patient-centered care, aiming to improve patient outcomes, and demonstrating a commitment to quality. Specialty NCQA accreditations focus on areas of patient programs, operations, and quality improvement, aligning organizations with contracting partners, and highlighting best practices.

Specialty Company NCQA Accreditations:

• ²»Á¼Ñо¿Ëù Corporation – Credentials Verification Organization
• Diamond Designation Program – Physician Quality
• ²»Á¼Ñо¿Ëù Pharmacy Services – Utilization Management
• ²»Á¼Ñо¿Ëù Management Company –ÌýUtilization Management
• Envolve Dental dba ²»Á¼Ñо¿Ëù Dental Services – Utilization Management
• Envolve Vision Benefits dba ²»Á¼Ñо¿Ëù Vision Services – Utilization Management
• 'Ohana Health Plan (Community Care Services [CCS] program) - Managed Behavioral Healthcare Organization

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URAC

Utilization Review Accreditation Commission provides accreditation standards to validate high quality healthcare to improve outcomes with continuous quality improvement and regulatory requirements. Specialty URAC accreditations focus on areas of pharmacy services, digital/telehealth, patient care management, and administrative management.

Specialty Company URAC Accreditations:

• ²»Á¼Ñо¿Ëù Pharmacy Services – Drug Therapy Management
• AcariaHealth – Specialty Pharmacy

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