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Health plan accreditation: NCQA, JCAHO, or both?
1Pennsylvania State University, University Park, USA.
Managed Care Quarterly
|March 3, 1999
Summary
Competition between managed care organization (MCO) accreditors like the National Committee for Quality Assurance (NCQA) and the Joint Commission may impact healthcare quality. Purchaser feedback suggests a need to evaluate the benefits and drawbacks of this competitive accreditation landscape.
Area of Science:
- Health Services Research
- Healthcare Management
- Quality Improvement in Healthcare
Background:
- Managed care organizations (MCOs) are accredited by the National Committee for Quality Assurance (NCQA) and the Joint Commission.
- The existence of multiple accrediting bodies raises questions about the impact of competition on accreditation quality and value.
- Understanding purchaser perspectives is crucial for evaluating the effectiveness of healthcare accreditation processes.
Purpose of the Study:
- To explore purchaser views on the advantages and disadvantages of competing accreditation processes for managed care organizations (MCOs).
- To assess the perceived value of MCO accreditation and the utilization of plan performance measures.
- To inform stakeholders about the implications of market competition in healthcare accreditation.
Main Methods:
- Two surveys were administered to purchasers and representatives from health plans and public health organizations.
- Participants had attended the Lovelace Health System (LHS) "Accreditation Experience" program, designed to educate on NCQA and Joint Commission processes.
- Data collected focused on opinions regarding accreditation processes, value, and performance measures.
Main Results:
- Purchaser feedback was gathered on the perceived benefits and drawbacks of both NCQA and Joint Commission accreditation.
- The study captured insights into the overall value attributed to MCO accreditation by key stakeholders.
- Information was collected on how purchasers use or view the use of plan performance measures in conjunction with accreditation.
Conclusions:
- The findings provide insights into the complex dynamics of a competitive market for managed care organization (MCO) accreditation.
- Purchaser perspectives are essential for guiding future improvements in healthcare accreditation standards and processes.
- Evaluating the impact of accreditation competition is vital for enhancing healthcare quality and accountability.