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Evolent Health Achieves NCQA Population Health Program Accreditation

by Jasmine Pennic 10/10/2019 Leave a Comment

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Evolent Health

– Evolent Health becomes the first company ever to achieve Population Health  Program Accreditation from NCQA with the status of Accredited–3 years.

– The Population Health Program Accreditation is the third NCQA Accreditation Evolent has achieved in 2019, with Evolent having also earned 3-Year Accreditation in both Utilization Management and Case Management in 2019.

– Three years is the longest accreditation time period NCQA designates for organizations.

Evolent Health, a company providing an integrated value-based care platform to providers and payers, today announced it is the first company ever to achieve Population Health Program Accreditation from the National Committee for Quality Assurance (NCQA), an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral healthcare organizations, preferred provider organizations, new health plans, physician organizations, credentials verification organizations, disease management programs and other health-related programs.

NCQA Population Health Program Accreditation Details

Evolent received NCQA’s Population Health Program Accreditation with the status of Accredited–3 years for Evolent’s Complex Care, Transition Care, Asthma, Coronary Artery Disease (CAD)/Hypertension, Chronic Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD) and Diabetes programs. The Population Health Program Accreditation is the third NCQA Accreditation Evolent has achieved in 2019, with Evolent having also earned 3-Year Accreditation in both Utilization Management and Case Management in 2019. Three years is the longest accreditation time period NCQA designates for organizations.

Population Health Program Accreditation Standards

NCQA awards the status of Accredited–3 years to organizations that demonstrate strong performance of the functions outlined in the standards for Population Health Program Accreditation. The Population Health Program Accreditation is organized into nine standards:

1. Program Description: The organization describes its population health management program, including its evidence base, and reviews and adopts new findings that are relevant to its program as they become available, as appropriate.

2. Data Integration: The organization collects and integrates data sources to conduct population health management functions.

3. Population Assessment: The organization conducts a population assessment to identify needs and characteristics of the population.

4. Population Segmentation: The organization segments or stratifies the population into actionable categories for intervention.

5. Targeted Interventions: The organization provides targeted interventions based on the individual’s needs.

6. Practitioner Support: The organization involves practitioners by providing them with information.

7. Measurement and Quality Improvement: The organization evaluates the effectiveness of the population health programs.

8. Individuals’ Rights and Responsibilities: The organization communicates the individual’s rights and responsibilities.

9. Delegation of Population Health Management: The organization carefully monitors functions performed by other organizations.

NCQA Accreditation standards are developed with input from various stakeholders and resources: health plans, population health management industry leaders and organizations, an expert panel and standing committees. NCQA Accreditation standards are purposely set high to encourage organizations to continuously enhance their quality; the standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement.

 

Impact of NCQA Accreditation

“We are honored to be the first organization ever to achieve Population Health Program Accreditation from NCQA,” said Evolent Health Chief Executive Officer Frank Williams. “This reflects our focus on doing what’s right for the patient regardless of how they enter the health care system, and our commitment to working with payers and providers to significantly improve care quality and the care experience. I commend the NCQA for taking the step to evolve its Disease Management programs into this Population Health Program accreditation because it encourages the industry to advance the way we care for people through earlier interventions, preventive care and a view of the whole person beyond a disease state.”

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Tagged With: Asthma, Behavioral Healthcare, Case Management, COPD, Data Integration, diabetes, Evolent Health, Heart, Hypertension, NCQA, Payers, Population Health, Population health management, Utilization Management, Value-Based Care

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