NCQA issues ACO accreditation details
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The Washington, D.C.-based NCQA stated it has worked with consumer advocates, purchasers and experts in the fields of healthcare delivery, health services research and managed care to develop a set of standards to evaluate ACOs.
The ACO accreditation program will assess organizations in seven domains:
ACO Structure and Operations: The organization clearly defines its organizational structure, demonstrates capability to manage resources and aligns provider incentives through payment arrangements and other mechanisms to promote the delivery of efficient and effective care.
Access to Needed Providers: The organization has sufficient numbers and types of practitioners and provides timely access to culturally competent healthcare.
Patient-Centered Primary Care: The primary-care practices within the organization act as medical homes for patients.
Care Management: The organization collects, integrates and uses data from various sources for care management, performance reporting and identifying patients for population health programs. The organization provides resources to patients and practitioners to support care management activities.
Care Coordination and Transitions: The organization facilitates timely exchange of information between providers, patients and their caregivers to promote safe transitions.
Patient Rights and Responsibilities: The organization informs patients about the role of the ACO and its services. It is transparent about its clinical performance and any performance-based financial incentives offered to practitioners.
Performance Reporting and Quality Improvement: The organization measures and publically reports performance on clinical quality of care, patient experience and cost measures. The organization identifies opportunities for improvement and brings together providers and stakeholders to collaborate on improvement initiatives.