This accreditation helps support organizations that coordinate LTSS by … ILS again decided to pursue the prestigious three-year NCQA accreditation in 2020 to … Develop personalized, patient-centered care plans. Learn More. Efficient and cost-effective case management processes and service delivery: Manage patients as they move between care settings. Want to save some time on your renewal survey? Use accreditation standards to align goals and approaches to case management across payers and providers. Helps plans measure performance and implement effective improvements to drive better outcomes of care and services for their members. health plans, employers) that your program meets the highest industry standards in delivering case management services. Systematically identifies patients who qualify for its programs. David Raths . Knowledge of URAC, NCQA, or CM standards of practice. Demonstrate to partners and clients (e.g. Goal is to provide simple, evidence-informed guardrails for the systems in which community health workers function. Helps ensure plans have a cohesive plan of action for addressing member needs across the continuum of care. We do not share your information with third parties. Organizations must meet program criteria to pursue the accreditation. 2. Case Management Accreditation Requirements. Use patient-centered assessment to determine care needs. This OnDemand event provides a focused and thorough examination of the HPA Standards for Population Health Management (PHM). It’s important for organizations to coordinate services effectively among caregivers, individuals, LTSS providers and clinicians. Use evidence-based standards to perform a gap analysis and determine improvement areas: Demonstrate the quality of your organization’s programs. Deliver a broad range of case management services for complex or high-risk populations. 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. This virtual seminar provides an in-depth explanation of NCQA's credentialing standards. 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. NCQA offers a virtual organization renewal survey for some accreditation and certification programs. This … Benefits of NCQA Case Management Accreditation . NCQA Case Management Accreditation requirements ensure that organizations can consistently use efficient and cost-effective case management processes and delivery of services. This OnDemand event provides a focused and thorough examination of the HPA Standards for Delegation (DEL). Program Description. ILS has been NCQA-accredited for Case Management for LTSS since 2017. The programs are: Long-term Services and Supports Distinction and Multicultural Health Distinction. Develop personalized, patient-centered care plans. This webinar series provides thorough explanations of HPA Standards for Credentialing (CR), Delegation (DEL), Member Experience (ME), Network Management (NET), Population Health Management (PHM), Quality Management & Improvement (QI), and Utilization Management (UM). Within six months or less, we will collaborate with your team to create a flexible framework for continuous … Press release. 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. Visit the LTSS Distinction section for more information. Many public health experts are advocating for rapidly scaling up the use of community health workers as part of the COVID response. Each program helps organizations improve their operations and initiatives in targeted areas and demonstrate their commitment to quality. Protect patients’ personal health information. Provide case management services for at least 6 months. 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. NCQA Case Management Accreditation provides a framework for implementing evidence-based best practices to ensure: Save your favorite pages and receive notifications whenever they’re updated. Please see the … What is population health management? The new PHM category also recognizes the important role of data analytics for identifying population needs, targeting resources to the right individuals and evaluating the impact of their strategy. 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. The updated standards combine important components of population health management such as wellness and complex case management, which were long-standing NCQA Accreditation requirements. NCQA Case Management Accreditation is for organizations that provide a broad range of case management services for complex and high-risk populations: 1. NCQA has complex case management and population health man agement requirements already established. Patient Identification and Assessment. Managed behavioral healthcare organizations. Interactive Survey Tool:Contains the complete standards and guidelines; you can also determine your organization’s survey readiness—the tool calculates your potential survey score. You will be prompted to log in to your NCQA account. Share this page with a friend or colleague by Email. Use accreditation status to reflect implementation of evidence-based standards for care and your program’s commitment to ongoing quality improvement. Population health management organizations. 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 Visit the Distinction in Multicultural Health Care section for more information. Organizations must meet program criteria to pursue the accreditation. Faculty will also facilitate short activities to simulate how to address requirements. Introduction to NCQA Credentialing Standards. “Achieving NCQA accreditation again for Case Management for LTSS is a testament to the work we do every day to serve the needs of vulnerable, frail and aging populations nationwide,” said Nestor Plana, Chairman/CEO of ILS. 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. Care Management; NCQA Panel to Create Standards for Community Health Worker Profession. Find information about NCQA LTSS Distinction here: 1. Manage valid sample size of individuals for NCQA evaluation, where standards require patient file review. Explaining HPA Standards for Population Health Management (PHM) OnDemand . Standards and Guidelines:The complete standards and guidelines, including the intent and scope of review. NCQA Health Plan Accreditation: Population Health Management Standards Category For California Department of Health Care Services Use only, do not distribute . 3. Faculty will also facilitate short activities to … Many payers across the country plan to pay practices a bonus for meeting NCQA standards. 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. NCQA Accreditation standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement. The application process for Accreditation, Certification and Distinction is now managed through My.NCQA. NCQA offers a Long-Term Services and Supports (LTSS) Distinction for organizations who provide case management services and coordinate social services for LTSS. Share this page with a friend or colleague by Email. 4. Perform functions covered in the accreditation program or arrange for the functions to be performed, directly or through a service agreement. 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 … Multicultural Health Care identifies organizations that lead the market in providing culturally and linguistically sensitive services, and working to reduce health care disparities. LTSS Distinction can support your organization in achieving these goals. MIAMI, Jan. 7, 2021 /PRNewswire/ -- Independent Living Systems ("ILS"), an industry leader in managing high-cost, complex member populations in the Medicare, M 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. Also NCQA recognition may be pivotal to future Medicare programs like the complex care management … 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 . Requirements cover these key areas: To see all program requirements, get the Standards & Guidelines document. Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. Set your organization apart … Explaining HPA Standards for Delegation (DEL) OnDemand. Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. Deliver a broad range of case management services for complex or high-risk populations. 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. Copyright © 2020 National Committee for Quality Assurance. You will be prompted to log in to your NCQA account. 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 This Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. Population Health Management. This Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. Required Standards for NCQA Case-Management Accreditation. 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. Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. Copyright © 2020 National Committee for Quality Assurance. Explaining NCQA Health Plan Accreditation (HPA) Series. If DHCS were to align with those requirements, the expectations and requirements of MCPs could potentially align with other agencies such as Covered California, and further reduce redundancies for the MCPs. Join the LTSS Best Practices Academy here. Provide access to qualified case management staff. We do not share your information with third parties. 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. May 15th, 2020. 2020 Case Management Standards and Guidelines Effective for surveys with a start date of July 1, 2020 onward. 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. 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. Manage valid sample size of individuals for NCQ… NCQA Case Management Accreditation addresses delivery of case management services, not just the organization’s internal processes. In explaining the reason for the update to the standards, NCQA’s Vice President for Product Design and Support Patricia M. Barrett said, “The future is integration: integration across providers and practices, integration between health plans and the delivery system, integration of … Uses up-to-date evidence-based information to develop its case-management program, and regularly updates the program with relevant findings and information. NCQA is a non-profit organization dedicated to improving health care quality. 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 … Part 1 will take place on May 26, 2020, 12:30pm-4:30pm (EST). This OnDemand event provides a focused and thorough examination of the HPA Standards for Utilization Management (UM). Provide case management services for at least 6 months. 2017 Case Management Standards and Guidelines Effective for surveys with a start date of January 30, 2017 - June 30, 2020. Save your favorite pages and receive notifications whenever they’re updated. More about Accreditation of Case Management for Long-Term Services and Supports (CM-LTSS) programs here. 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 Standards Veronica C. Locke, MHSA October 24, 2017 Standard statement Statement about acceptable performance or results Intent statement Sentence describing importance of standard Summary of changes Changes from year to year. Case management is a vital part of the health care delivery system. “Case Management Accreditation moves us closer to measuring quality across population health management initiatives,” said Margaret E. O’Kane, President, NCQA. Looking for the Application Packet for This Product? Read about NCQA's Case Management (CM) program here. 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. Explaining HPA Standards for Utilization Management (UM) OnDemand . Provider-based organizations (e.g., medical groups, hospitals, integrated delivery systems). ILS has been NCQA-accredited for Case Management for LTSS since 2017. 2. Standards help plans in: Quality Management and Improvement. Care Planning. 2 Scoring Level of performance necessary to receive specified percentage of points Data source Documentation organizations use to demonstrate … Use patient-centered assessment to determine care needs. NCQA is a non-profit organization dedicated to improving health care quality. 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. 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. Perform functions covered in the accreditation program or arrange for the functions to be performed, directly or through a service agreement. Patient monitoring to track care-goal progress. 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