Quality and Accreditation

NCQA Accreditation

National Committee for Quality Assurance (NCQA) Accreditation is the nation’s most trusted independent source for driving health care improvement that results in bottom-line value for health care purchasers.1

NCQA Badges for Accredited Health Plan, Commendable Health Plan, HEDIS Compliance, and Long-Term Services and Supports Distinction

Optima Health is pleased that NCQA has recognized our quest for excellence. For 21 and 22 years, respectively, Optima Health Plan has received NCQA accreditation for its Medicaid HMO product and commercial HMO/POS health plans. In 2013, Optima Health Plan received NCQA accreditation for its Marketplace HMO health plans.2 

Learn more about NCQA Accreditation

LTSS Distinction

LTSS has become increasingly important for health plans to demonstrate their ability to effectively coordinate services between caregivers, individuals, LTSS providers and clinicians. Health plans that coordinate LTSS should implement best practices for person-centered care planning and effective care transitions, and for measuring quality improvement to support people living optimally in their preferred setting.

LTSS Distinction for Health Plans helps support health plans that provide managed care services and coordinate social services for LTSS. NCQA’s standards provide a framework for Optima Health to deliver efficient, effective, person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state requirements.

Core areas of focus drive organizational effectiveness and efficiency:
• Person-Centered Care Planning.
• Care Transitions.
• Coordination of Services.
• Critical Incident Management System.
• Qualifications and Assistance for LTSS Providers.

Awards