Helps ensure plans have a cohesive plan of action for addressing member needs across the continuum of care. ILS has been NCQA-accredited for Case Management for LTSS since 2017. Systematically identifies patients who qualify for its programs. More about Accreditation of Case Management for Long-Term Services and Supports (CM-LTSS) programs here. NCQA offers a Long-Term Services and Supports (LTSS) Distinction for organizations who provide case management services and coordinate social services for LTSS. Faculty will walk participants through a detailed explanation of each Credentialing standard and lead participants through scenarios that are designed to mimic real-life credentialing scenarios. Part 1 will take place on May 26, 2020, 12:30pm-4:30pm (EST). Program Description. Protect patients’ personal health information. This OnDemand event provides a focused and thorough examination of the HPA Standards for Utilization Management (UM). You will be prompted to log in to your NCQA account. “Case Management Accreditation moves us closer to measuring quality across population health management initiatives,” said Margaret E. O’Kane, President, NCQA. Also NCQA recognition may be pivotal to future Medicare programs like the complex care management … Provide case management services for at least 6 months. Share this page with a friend or colleague by Email. ILS again decided to pursue the prestigious three-year NCQA accreditation in 2020 to … 1 Overview of the NCQA Credentialing Standards Presentation for NAMSS Conference By: Veronica C. Locke September 20, 2016 Objectives/Agenda •Review how to read a standard. NCQA Case Management Accreditation provides a framework for implementing evidence-based best practices to ensure: Save your favorite pages and receive notifications whenever they’re updated. ILS has been NCQA-accredited for Case Management for LTSS since 2017. MIAMI, Jan. 7, 2021 /PRNewswire/ -- Independent Living Systems ("ILS"), an industry leader in managing high-cost, complex member populations in the Medicare, M Case management is a vital part of the health care delivery system. “Achieving NCQA accreditation again for Case Management for LTSS is a testament to the work we do every day to serve the needs of vulnerable, frail and aging populations nationwide,” said Nestor Plana, Chairman/CEO of ILS. ILS has been NCQA-accredited for Case Management for LTSS since 2017. Explaining HPA Standards for Population Health Management (PHM) OnDemand . 4. Deliver a broad range of case management services for complex or high-risk populations. ILS again decided to pursue the prestigious three-year NCQA accreditation in 2020 to align with the company's commitment to enhancing quality of life by improving health outcomes, reducing costs, and addressing social determinants of health. We do not share your information with third parties. URAC’s Case Management accreditation standards require companies to establish the policies, procedures and structure needed for optimal performance across four main principles of case management: care coordination, transitions of care, patient engagement and advocacy. Use accreditation standards to align goals and approaches to case management across payers and providers. Press release. NCQA Standards Veronica C. Locke, MHSA October 24, 2017 Standard statement Statement about acceptable performance or results Intent statement Sentence describing importance of standard Summary of changes Changes from year to year. Many public health experts are advocating for rapidly scaling up the use of community health workers as part of the COVID response. Faculty will also facilitate short activities to … NCQA offers a virtual organization renewal survey for some accreditation and certification programs. Share this page with a friend or colleague by Email. It’s important for organizations to coordinate services effectively among caregivers, individuals, LTSS providers and clinicians. Deliver a broad range of case management services for complex or high-risk populations. Join the LTSS Best Practices Academy here. Develop personalized, patient-centered care plans. Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Contractual Services (Quality Solutions Group), Advertising and Marketing Your NCQA Status, Distinction in Multicultural Health Care section. Visit the Distinction in Multicultural Health Care section for more information. May 15th, 2020. NCQA is a non-profit organization dedicated to improving health care quality. This OnDemand event provides a focused and thorough examination of the HPA Standards for Delegation (DEL). Save your favorite pages and receive notifications whenever they’re updated. Knowledge of URAC, NCQA, or CM standards of practice. 2017 Standards Concepts 21 Care Management and Support Care Coordination and Care Transitions Performance Measurement & Quality Improvement Identifying patients for care management Person-centered care plan development Management of lab/imaging results Tracking and managing patient referrals Care transitions Collecting and analyzing performance data Setting goals Improving practice … Provider-based organizations (e.g., medical groups, hospitals, integrated delivery systems). NCQA Case Management Accreditation requirements ensure that organizations can consistently use efficient and cost-effective case management processes and delivery of services. Patient Identification and Assessment. Managed behavioral healthcare organizations. Standards and Guidelines:The complete standards and guidelines, including the intent and scope of review. NCQA Case Management Accreditation is for organizations that provide a broad range of case management services for complex and high-risk populations: 1. Efficient and cost-effective case management processes and service delivery: Manage patients as they move between care settings. Copyright © 2020 National Committee for Quality Assurance. Manage valid sample size of individuals for NCQ… We do not share your information with third parties. Benefits of NCQA Case Management Accreditation . Provide case management services for at least 6 months. health plans, employers) that your program meets the highest industry standards in delivering case management services. The updated standards combine important components of population health management such as wellness and complex case management, which were long-standing NCQA Accreditation requirements. by NCQA; HEDIS was initiated as a national cooperative project between several health plans and leading employers such as GTE, Digital and Xerox with the goal being to create a standard set of health plan quality indicators, covering preventive care processes and outcomes, with This Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. NCQA Health Plan Accreditation: Population Health Management Standards Category For California Department of Health Care Services Use only, do not distribute . Want to save some time on your renewal survey? Requirements cover these key areas: To see all program requirements, get the Standards & Guidelines document. Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. You will be prompted to log in to your NCQA account. Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Contractual Services (Quality Solutions Group), Advertising and Marketing Your NCQA Status. Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. The new PHM category also recognizes the important role of data analytics for identifying population needs, targeting resources to the right individuals and evaluating the impact of their strategy. Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. Read about NCQA's Case Management (CM) program here. Manage valid sample size of individuals for NCQA evaluation, where standards require patient file review. Use accreditation status to reflect implementation of evidence-based standards for care and your program’s commitment to ongoing quality improvement. Use evidence-based standards to perform a gap analysis and determine improvement areas: Demonstrate the quality of your organization’s programs. Explaining HPA Standards for Utilization Management (UM) OnDemand . Explaining NCQA Health Plan Accreditation (HPA) Series. NCQA accredits and certifies a wide range of health care organizations, recognizes physicians and physician groups in key clinical areas and manages the evolution of HEDIS, the tool the nation Each program helps organizations improve their operations and initiatives in targeted areas and demonstrate their commitment to quality. If DHCS were to align with those requirements, the expectations and requirements of MCPs could potentially align with other agencies such as Covered California, and further reduce redundancies for the MCPs. Organizations must meet program criteria to pursue the accreditation. NCQA Case Management Accreditation addresses delivery of case management services, not just the organization’s internal processes. Standards help plans in: Quality Management and Improvement. NCQA has complex case management and population health man agement requirements already established. Population health management organizations. The programs are: Long-term Services and Supports Distinction and Multicultural Health Distinction. Demonstrate to partners and clients (e.g. Maintenance of Continuing Education appropriate to care management and renewal of any certifications Demonstrated accountability and skills in analysis, decision making, time management and oral, written communication Familiarity with available resources that include any applicable regulations, reimbursement guidelines, community …
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