NCQA releases ACO guidelines

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Accountable care organizations have been hailed as being able to save healthcare just as often as they’ve been criticized as being too risky. In an effort to provide some sense of certainty about an ACO’s ability to reach the so-called triple aim of reducing cost, improving quality and enhancing patient experience, the National Committee for Quality Assurance (NCQA) released on Monday its standards and guidelines which are the basis of its ACO accreditation program. “NCQA accreditation is an independent evaluation of whether an ACO really can coordinate and be accountable for the efficient, patient-centered care expected of ACOs,” said NCQA President Margaret E. O’Kane. “Accreditation can assure patients that their ACO focuses on their care, and it shows payers and providers which ACOs are likely to be good partners.” [See also: ACO program is asking too much, says expert.] The NCQA’s ACO accreditation program standards were developed over two years with the help of a task force of experts spanning the array of stakeholders in the healthcare industry. “Accreditation identifies which ACOs are likely to be good partners” and serves as “a roadmap and vehicle for provider-led groups to show their abilities,” the NCQA noted in briefing materials released to the media. NCQA’s ACO accreditation standards require ACOs to demonstrate capabilities in:

1. program operations
2. access and availability
3. primary care
4. care management
5. care coordination and transitions
6. patient rights and responsibilities
7. performance reporting