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Why Is NCQA Accreditation Important?

By Wellsource, Inc.

If you are considering health plan accreditation, you have likely heard of the National Committee for Quality Assurance (NCQA). NCQA health plan accreditation is a widely-recognized, evidence-based program that works to ensure quality improvement and measurement through aligning organizations with a comprehensive framework.  

More than 1,000 health plans have earned NCQA Accreditation and achieving accreditation is a lengthy process, representing a lot of work. So why do health plans do it? 

NCQA accreditation standards help health plans and other organizations align future initiatives with issues that are front and center for employers and states. Through the accreditation process, organizations are able to perform a gap analysis and identify areas for improving their evidence-based practices. The roadmap for improvement can include paying close attention to:  

  • Quality management and improvement 
  • Population health management 
  • Network management 
  • Credentialing and recredentialing 
  • Members’ rights and responsibilities 
  • Member connections 
  • Medicaid benefits and services 

The evaluation of these programs is based on clinical performance as well as consumer experience. The rigor of this process is one way that accredited organizations can signal their commitment to best practices and quality measures. 

The Benefit of Working with Certified Vendors to Achieve Health Plan Accreditation 

As described above, seeking accreditation is an arduous process. And for good reason —if it were easy, just anyone could do it. Thankfully, NCQA has streamlined part of the process through its vendor certification program, in which vendors can be vetted for quality by NCQA—see the full directory of approved vendors and accredited organizations here 

Let’s take a look at the benefits of going with a certified vendor in the example use case of using health risk assessments (HRAs). Health plan accreditation requires the use of HRAs and self-management tools—and though organizations seeking accreditation can opt to build their own HRA or partner with a third-party for the solution, many find themselves weighing the pros and cons of building their own solution and opting instead to partner with a trustworthy vendor. When health plans work with vendors that have already passed NCQA’s thorough review, they receive oversight relief for all the standards that apply. 

Interested in other accreditation options?
Click hereto learn more about how Wellsource products help organizations prove to accrediting bodies that their programs can measure health risks, segment and stratify populations, target interventions, and provide health education and self-management tools. Explore health plan accreditation with Wellsource.

NCQA certification is a testament to a company’s commitment to participant experience and scientific validity. The certification process requires a substantial amount of time and resources — including usability testing, documentation, and product review and enhancement. Companies use NCQA-certified HRAs and self-management tools because they know they provide quality data and a quality experience for the individuals who take them. 

Wellsource: NCQA Certified, Committed to Quality and Excellence 

Wellsource is a certified vendor with NCQA. We were the first health appraisal vendor to be certified by NCQA and have received certification continuously since 2008. This certification signals our commitment to providing a best-in-class solution based on industry best practices and evidence-based research that will support health and improve outcomes. 

Ready to learn more about the NCQA certification process? Download our case study to learn how vendors earn NCQA certification, and the value this recognition has brought to Wellsource clients for over a decade running. 


Tags: health risk assessment, HRA, ncqa, health plans

"Good health is your greatest asset. You will never regret a decision to take better care of your health."

Don Hall, DrPH, CHES, Founder Wellsource