Quality and 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
Optima Health is pleased that NCQA has recognized our quest for excellence. Optima Health Plan has consistently received NCQA accreditation since 1997 for its commercial HMO/POS health plans, 1998 for its Medicaid HMO product and 2013 for its Marketplace HMO health plans.
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.