Knowledge of URAC, NCQA, or CM standards of practice. This virtual seminar provides an in-depth explanation of NCQA's credentialing standards. NCQA offers a Distinction in Multicultural Health Care that identifies organizations—health plans, MCOs, MBHOs, wellness and population health organizations, and others—that lead the market in providing culturally and linguistically sensitive services, and working to reduce health care disparities. Many payers across the country plan to pay practices a bonus for meeting NCQA standards. Managed behavioral healthcare organizations. Population health management organizations. MIAMI, Jan. 7, 2021 /PRNewswire/ -- Independent Living Systems ("ILS"), an industry leader in managing high-cost, complex member populations in the Medicare, M 2 Scoring Level of performance necessary to receive specified percentage of points Data source Documentation organizations use to demonstrate … 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. This Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. David Raths . Join the LTSS Best Practices Academy here. This OnDemand event provides a focused and thorough examination of the HPA Standards for Delegation (DEL). This webinar series provides thorough explanations of HPA Standards for Credentialing (CR), Delegation (DEL), Member Experience (ME), Network Management (NET), Population Health Management (PHM), Quality Management & Improvement (QI), and Utilization Management (UM). 2016 Complete Overview of the NCQA Standards Session Code: TU13 Date: Tuesday, September 20, 2016 Time: 2:30pm - 4:00pm Total CE Credits: 1.5 Presenter(s): Veronica C. Locke, MHSA . 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. Helps plans measure performance and implement effective improvements to drive better outcomes of care and services for their members. Case management is a vital part of the health care delivery system. NCQA Case Management Accreditation evaluates organizations performing case management services that typically focus on patients who are at high risk of experiencing costly hospitalizations or poor health outcomes because of complex social, behavioral or medical needs. Provide case management services for at least 6 months. ILS has been NCQA-accredited for Case Management for LTSS since 2017. Required Standards for NCQA Case-Management Accreditation. Organizations must meet program criteria to pursue the accreditation. Helps ensure plans have a cohesive plan of action for addressing member needs across the continuum of care. 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. Looking for the Application Packet for This Product? NCQA Case Management Accreditation addresses delivery of case management services, not just the organization’s internal processes. Provide access to qualified case management staff. 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 Want to save some time on your renewal survey? 2. Explaining HPA Standards for Population Health Management (PHM) OnDemand . Use evidence-based standards to perform a gap analysis and determine improvement areas: Demonstrate the quality of your organization’s programs. Manage valid sample size of individuals for NCQA evaluation, where standards require patient file review. NCQA is a non-profit organization dedicated to improving health care quality. Use patient-centered assessment to determine care needs. Long-Term Services and Supports Distinction evaluates NCQA-Accredited case management organizations that coordinate LTSS and want to demonstrate they have the processes to effectively deliver person-centered care. 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. 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 … On July 15, 2020, NCQA awarded Western Reserve Area Agency on Aging Accreditation of Case Management for Long-term Services and Supports (LTSS) for 3 years. Use accreditation status to reflect implementation of evidence-based standards for care and your program’s commitment to ongoing quality improvement. The programs are: Long-term Services and Supports Distinction and Multicultural Health Distinction. Interactive Survey Tool:Contains the complete standards and guidelines; you can also determine your organization’s survey readiness—the tool calculates your potential survey score. Program Description. You will be prompted to log in to your NCQA account. Deliver a broad range of case management services for complex or high-risk populations. “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. Please see the … Within six months or less, we will collaborate with your team to create a flexible framework for continuous … 2017 Case Management Standards and Guidelines Effective for surveys with a start date of January 30, 2017 - June 30, 2020. NCQA Accreditation standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement. NCQA Case Management Accreditation is for organizations that provide a broad range of case management services for complex and high-risk populations: 1. Care Management; NCQA Panel to Create Standards for Community Health Worker Profession. It’s a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet comprehensive medical, behavioral and social needs of patients and their families while promoting quality, cost-effective outcomes. Goal is to provide simple, evidence-informed guardrails for the systems in which community health workers function. Patient monitoring to track care-goal progress. It’s important for organizations to coordinate services effectively among caregivers, individuals, LTSS providers and clinicians. NCQA Case Management Accreditation provides a framework for implementing evidence-based best practices to ensure: Efficient and cost-effective case management processes and service delivery: Manage patients as they move between care settings. The standards are designed for organizations providing case management services that include patient identification and assessment, care planning, care monitoring and care transitions to meet the needs of patients and their families; for example: NCQA Case Management Accreditation is for organizations that provide a broad range of case management services for complex and high-risk populations: An organization seeking case management accreditation designates the program it wants evaluated; for example: Find information about NCQA Case Management Accreditation here: NCQA offers several related programs for organizations eligible for the Health Plan Accreditation. Share this page with a friend or colleague by Email. Benefits of NCQA Case Management Accreditation . You will be prompted to log in to your NCQA account. Many public health experts are advocating for rapidly scaling up the use of community health workers as part of the COVID response. Protect patients’ personal health information. Organizations must meet program criteria to pursue the accreditation. Manage valid sample size of individuals for NCQ… Perform functions covered in the accreditation program or arrange for the functions to be performed, directly or through a service agreement. This OnDemand event provides a focused and thorough examination of the HPA Standards for Population Health Management (PHM). Press release. More about Accreditation of Case Management for Long-Term Services and Supports (CM-LTSS) programs here. 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. 3. Provide case management services for at least 6 months. Develop personalized, patient-centered care plans. We do not share your information with third parties. Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. 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. NCQA Health Plan Accreditation: Population Health Management Standards Category For California Department of Health Care Services Use only, do not distribute . Part 1 will take place on May 26, 2020, 12:30pm-4:30pm (EST). What is population health management? Uses up-to-date evidence-based information to develop its case-management program, and regularly updates the program with relevant findings and information. Provider-based organizations (e.g., medical groups, hospitals, integrated delivery systems). Also NCQA recognition may be pivotal to future Medicare programs like the complex care management … This OnDemand event provides a focused and thorough examination of the HPA Standards for Utilization Management (UM). Set your organization apart … Population Health Management. Explaining HPA Standards for Delegation (DEL) OnDemand. ILS has been NCQA-accredited for Case Management for LTSS since 2017. Patient Identification and Assessment. This accreditation helps support organizations that coordinate LTSS by … Visit the Distinction in Multicultural Health Care section for more information. Faculty will also facilitate short activities to … NCQA Case Management Accreditation evaluates organizations performing case management services that typically focus on patients who are at high risk of experiencing costly hospitalizations or poor health outcomes because of complex social, behavioral or medical needs. 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