Selecting a Company for Your Prevention Program – Accreditation (Column 3)


Now that you are looking for a company that bases its approach on the science of Preventive Medicine, what else should you be looking for?  Well just as in medicine where physicians can become Board Certified, which demonstrates that they have met certain published standards in their specialty, or hospitals achieve JCAHO accreditation or companies achieve ISO accreditation; so too in the field of prevention and chronic care management there are accreditations that organizations can achieve. Two of the accrediting organizations in this area are NCQA (the National Committee for Quality Assurance) and URAC.

From the NCQA website:

The National Committee for Quality Assurance is a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality. Since its founding in 1990, NCQA has been a central figure in driving improvement throughout the health care system, helping to elevate the issue of health care quality to the top of the national agenda.

The NCQA seal is a widely recognized symbol of quality. Organizations incorporating the seal into advertising and marketing materials must first pass a rigorous, comprehensive review and must annually report on their performance. For consumers and employers, the seal is a reliable indicator that an organization is well-managed and delivers high quality care and service.

And from the URAC website:

URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation, education and measurement programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry.

And a quick explanation of accreditation from URAC

What is accreditation? Accreditation is a process by which an impartial organization (URAC) will review a company’s operations to ensure that the company is conducting business in a manner consistent with national standards.

While as an example NCQA lists the following Standards areas for their Accreditation in Wellness and Health Promotion:

    1. Employer and Plan Sponsor Engagement
    2. Privacy and Confidentiality
    3. Engaging the Population
    4. Health Appraisal
    5. Identification and Targeting
    6. Self-Management Tools
    7. Health Coaching
    8. Rights and Responsibilities
    9. Measuring Effectiveness
    10. Delegation
    11. Incentives Management (No Point Value)
    12. Reporting WHP Performance (No Point Value)

And here are some of NCQA’s Performance measures that each accredited entity must measure and report on:

Performance Measures Required for WHP Accreditation

  • Health Appraisal Completion
  • Health Promotion for the Population
  • Staying Healthy
  • Prevalence of Core Risks Identified on HAs
  • Number of Core Risks Identified on HAs
  • Participation
  • Risk Reduction-Overall
  • Risk Reduction-BMI Reduction and Maintenance
  • Risk Reduction-Smoking or Tobacco Use Quit Rate
  • Risk Reduction-Physical Activity Level

Companies can receive a number of different accreditations or certifications from these organizations depending upon the services they offer and level of those services. Many large employers as well as government agencies require accreditation from vendors providing prevention and disease management programs. Companies that choose to become accredited have opened up their operations to an outside review from these organizations and must continue to maintain their operations and meet new standards through ongoing reaccreditations.

When looking for a vendor, accreditation is something that all companies should add to their requirements list.

You can go to URAC or NCQA’s website and learn more about accreditation as well as find accredited companies.

Neither URAC nor NCQA has approved of or are in anyway affiliated with this blog.

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About Fred Goldstein

President and Founder of Accountable Health, LLC. My background includes over 25 years of health care experience in hospital administration, health plan management, disease management and population health.
This entry was posted in Health Risk Assessment, Preventive Medicine, The Industry, U.S. Preventive Medicine, Uncategorized, Wellness and tagged , , , , , , , , , , , , , , , , . Bookmark the permalink.

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