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Health Plan Accreditation |
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Employers, state and federal governments, are increasingly interested in assessing and monitoring the quality of care that is being provided by the healthcare plans. External accreditation is one of the key tools used by healthcare plan purchasers in judging the quality of the plans. The accreditation process carried out by accrediting bodies such as Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), National Committee for Quality Assurance (NCQA) and several others distinguish health plans based on scored quality metrics and require the health plan to complete the process on time and with precision. MetricStream provides a repository to store, organize, assess and submit accreditation and compliance documentations such as case records, operating procedures, meeting minutes and other documents to agencies and regulators in a streamlined manner. Submissions can be periodic or event-based and support reporting formats and data exchange standards. The records can be organized and grouped in a logical fashion with the ability to create any number of sub-categories and tree-like hierarchies. Interfaces with survey systems such as NCQA's Interactive Survey System (ISS), the web-based tool for health plan accreditation, are provided to facilitate submission to the accreditation entities. Self assessments can be triggered to conduct mock-reviews on compliance documentation and audit-readiness. The system provides the capability to configure and execute surveys and self-assessments based on predefined templates and schedules for designated executives. Each element can be scored, with recommendations inserted as appropriate. MetricStream provides capabilities to manage and submit evidence documentation online using various data exchange standards. Analyst Research
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