Quality Indicators Associated With the Level of NCQA Accreditation

Am J Med Qual. 2018 Jan/Feb;33(1):43-49. doi: 10.1177/1062860617702963. Epub 2017 Apr 11.

Abstract

The National Committee for Quality Assurance (NCQA) is the most widely used accrediting body of health plans, but no study has explored how differences in health quality affect the accreditation level. Consumers may benefit as they guide health insurance purchasing decisions toward a cost-quality evaluation. The authors conducted a multinomial logistic regression analysis using data from the 2015 NCQA Quality Compass of 351 health plans. This study's outcome variable represented NCQA accreditation at 3 levels: accredited, commendable, and excellent. The authors examined the relationship of patient satisfaction, monitoring and prevention activities, appropriate care, and readmission rates on accreditation level. Satisfaction and monitoring and prevention activities were significantly associated with higher levels of accreditation in all analyses, but readmission was not. The expanded coverage of the Affordable Care Act provides an opportunity for health plans to market to consumers the benefits of accreditation to foster higher quality care.

Keywords: NCQA; accreditation; health plans; quality.

MeSH terms

  • Accreditation / standards*
  • Humans
  • Insurance, Health / standards*
  • Logistic Models
  • Patient Readmission / statistics & numerical data
  • Patient Safety / standards*
  • Patient Satisfaction*
  • Preventive Medicine / standards
  • Quality Assurance, Health Care / standards
  • Quality Indicators, Health Care
  • United States