• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to secondary sidebar
  • Skip to footer

  • Opinion
  • Health IT
    • Behavioral Health
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Patient Engagement
    • Population Health Management
    • Revenue Cycle Management
    • Social Determinants of Health
  • Digital Health
    • AI
    • Blockchain
    • Precision Medicine
    • Telehealth
    • Wearables
  • Life Sciences
  • Investments
  • M&A
  • Value-based Care
    • Accountable Care (ACOs)
    • Medicare Advantage

NCQA Accountable Care Organization Accreditation Overview

by Fred Pennic 11/17/2011 Leave a Comment

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

The National Committee for Quality Assurance (NCQA) is launching a new accreditation program for Accountable Care Organizations on November 21st. ACO accreditation is an independent evaluation of healthcare delivery organizations’ ability to coordinate the high quality, efficient, patient centered care expected of ACOs. I decided to write a brief comprehensive overview based on the presentation and white paper provided by NCQA.

Why ACO Accreditation Matters:

  • Variation in capabilities and readiness make ACOs risky for payers, patients.
  • Assures patients their ACOs focus on them and their care
  • Aligns purchasers with common expectations
  • Identifies which ACOs are likely to be good partners
  • A roadmap & vehicle for provider led groups to show their abilities

Levels of Accreditation-the program will have three levels of scoring, to allow organizations with varying levels of capability the opportunity to be accredited

Level 1

  •  For organizations in the formation or transformation stage; have not reached full ACO capability
  • Organizations have basic infrastructure and some capabilities outlined in standards.
  • Length of status: 2 years
  • 50 points
  • Must Pass Elements: None

Level 2

  • For well-established organizations that strongly demonstrate the capabilities outlined in the standards
  • Length of status: 3 years
  • 70 points
  • Must Pass Elements: Yes- Report core performance measures and patient experience, evaluate and improve patient-centered primary care, and have complete data on a minimum threshold of patients

Level 3

  • Achieve Level 2 and demonstrate strong performance or improvement across the triple aim
  • Length of status: 3 years
  • 70 points and performance against triple aim
  • Must Pass Elements: Yes: Same as Level 2

Why Measure Structure and Process? 

  • Most ACOs are not ready to be judged mainly on outcomes
  • Evidence-based standards can identify which ACOs are most likely to deliver on the triple aim

Accreditation Standards Capability

The ACO program contains 7 categories, broken into 65 elements; element -level point allocation is based on 100 points; there are 4 must pass elements. These fall into several important areas.

  1. Program Operations-The infrastructure to coordinate providers
  2. Access & Availability- Ensure the ACO has sufficient numbers, types of practitioners, timely access to care, etc.
  3. Primary Care- Promotes the delivery of patient centered primary care by providing patients access to patient-centered medical homes, etc.
  4. Care Management- Collects, integrates and uses data from various sources for care management and performance reporting, etc.
  5. Care Coordination and Transitions- Has a coordinated system to facilitate timely information exchanges between multiple providers
  6. Patient Rights and Responsibilities- States its commitment to treating patients in a matter that respects their rights and privacy, etc.
  7. Performance Reporting- Strives to improve the quality of services by evaluating it’s performance using valid measures, make results available to the public and ACO providers

For more information:

– Read the NCQA white paper (.pdf)

– check out the NCQA presentation (.pdf)

 

 

 

 

 

 

 

 

 

 

 

 

 

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Tagged With: Accountable Care Organizations, ACO, NCQA

Tap Native

Get in-depth healthcare technology analysis and commentary delivered straight to your email weekly

Reader Interactions

Primary Sidebar

Subscribe to HIT Consultant

Latest insightful articles delivered straight to your inbox weekly.

Submit a Tip or Pitch

Featured Insights

Digital Health Funding Q3 2025: Choppy Undercurrents Beneath a Steady Surface

Most-Read

Qualtrics Acquires Press Ganey Forsta for $6.75B to Create the Most Comprehensive AI Experience Platform

Qualtrics Acquires Press Ganey Forsta for $6.75B to Create the Most Comprehensive AI Experience Platform

Pfizer and Trump Administration Announce Landmark Agreement to Lower Drug Costs

Pfizer and Trump Administration Announce Landmark Agreement to Lower Drug Costs

KLAS Report: Epic's Native Ambient Speech Tool Reshapes Customer AI Strategies

KLAS Report: Epic’s Native Ambient Speech Tool Reshapes Customer AI Strategies

Epic Unveils MyChart Central and New APIs to Advance Interoperability at Open@Epic

Epic Outlines Roadmap for Next-Generation Data Sharing at Open@Epic

Epic Launches Comet: A New AI Platform to Predict Patient Health Journeys

Epic Launches Comet: A New AI Platform to Predict Patient Health Journeys

RevSpring to Acquire Kyruus Health, Creating a Unified Patient Experience

RevSpring to Acquire Kyruus Health, Creating a Unified Patient Experience

Oracle Confirms Layoffs in Kansas City

Oracle Confirms Layoffs in Kansas City

Philips Future Health Index 2025: AI and Digital Tech Can Help Solve Cardiac Care Crisis

Philips Future Health Index 2025: AI and Digital Tech Can Help Solve Cardiac Care Crisis

Optain Health Secures $26M to Advance AI-Powered Retinal Screening

Optain Health Secures $26M for AI-Powered Retinal Screening

Sutter Health and Epic Launch "Sutter Sync" to Optimize Remote Chronic Care

Sutter Health and Epic Launch “Sutter Sync” to Optimize Remote Chronic Care

Secondary Sidebar

Footer

Company

  • About Us
  • Advertise with Us
  • Reprints and Permissions
  • Submit An Op-Ed
  • Contact
  • Subscribe

Editorial Coverage

  • Opinion
  • Health IT
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Population Health Management
    • Revenue Cycle Management
  • Digital Health
    • Artificial Intelligence
    • Blockchain Tech
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • Value-Based Care
    • Accountable Care
    • Medicare Advantage

Connect

Subscribe to HIT Consultant Media

Latest insightful articles delivered straight to your inbox weekly

Copyright © 2025. HIT Consultant Media. All Rights Reserved. Privacy Policy |