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| Health Plan Accreditation Back to Consumer Guide list |
| What is accreditation? |
Accreditation is recognition of the quality standards achieved by an organization. NCQA accreditation is viewed by many as the seal of approval for health plans. As of July 31, 1997, fifty-three percent of the nation's managed care organizations now participate in this voluntary accreditation. Accreditation is an achievement; currently, just half of accredited plans have full accreditation, and only eighteen percent receive full accreditation on initial review. | ||||||||||||||||||||||||||||||||
| Who sets the standards? | NCQA, the National Committee for Quality Assurance is an independent, nonprofit organization whose mission is to assess and report health plan quality. Besides accreditation, NCQA is a clearinghouse for information from a wide range of providers, professional societies and agencies used to create the standards presented in the Health Plan Employer Data Information Set (HEDIS®). A selection of the results of HEDIS® measures on satisfaction, use of services and effectiveness of care are presented in this report on quality. | ||||||||||||||||||||||||||||||||
| How are health plans graded? |
EXCELLENT The health plan demonstrates levels of service and clinical quality that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement. Plans designated as "Excellent" must also achieve clinical performance and patient satisfaction that are in the highest range of national or regional performance. COMMENDABLE ACCREDITED PROVISIONAL
ACCREDITATION DENIED |
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| Accreditation status of health plans as of July 7, 2006. Data verified by NCQA |
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