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NCQA Compliance Report

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Recommended: A synopsis of patient centered medical homes

From the lessons learned from the patients-centered medical home (PCMH), the NCQA was motivated to develop an accreditation process for ACOs. The NCQA tried to accommodate the lessons that they learned from the PCMH programs so as to develop a very excellent program that recognizes that provisions of the high-quality primary care are the foundation of good health. NCQA also recognizes that although the evaluation of the result is very imperative, it is also critical to assess the ACOs using evidenced based criteria. Through these measures, the organizations can learn more about what is needed and what they need to do so that they can be compliant. They can also learn the key elements required for successful transformation of the ACO. It can …show more content…

The NCQA ACO program is meant to create an alignment of the healthcare plan with the state, employer, and even the federal purchasers need to form a leverage that will be used in the promoting of organizations to make a transformation for healthcare providers (Carver & Jesie, 2011). The best thing about the ACO accreditation is that it helps making a determination of whether the various organizations have the right infrastructure for accountability. The purchasers are more concerned with whether the organization is in a better position to serve. They are also in need of assurance that they will get quality care from the organizations. Through the process of NCQA accreditation, the purchaser gets the right information (Blazej, …show more content…

The accredited organizations are expected to hold a certain degree of transparency, especially in performance-based payments (Schneider, 2011). The NCQA also puts a requirement on the ACOs to report their performance and even divulges the performance reports to the providers so that their performance can be assessed. Through the practices, the ACOs have adopted a lot of transparency. Transparency is not a simple process, but it serves as an imperative measure of performance. Organizations that demonstrate a lot of transparency tend to gain a good reputation (national committee quality assurance, 2014). They are likely to attract a larger customer base than other organizations that do not demonstrate any form of transparency. On the other hand, transparency comes with responsibility and accountability; therefore, transparent organizations have a lot of accountability. These organizations are aware that there is a need to report to the public, and they are, therefore, responsible for their actions. ACOs that have adopted the accreditation tend to be very responsible and accountable (The American Journal of Managed Care,

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They have to keep the expenses low. For this purpose, these organizations must include local hospitals, physicians and specialists and other primary care providers who have attained their recognition as PCMH. These all the members of ACO are in agreement to keep the costs down along with a maximum level of providing medical care to patients throughout their journey. These goals make the accountable organizations financially responsible for those patients along the care continuum. In contrast, PCMH has to only view and figure that an organization is able to better deliver the personalized health care.

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