DENVER--(BUSINESS WIRE)--HGS Healthcare, LLC (HGS Healthcare) announced today that its affiliate, HGS AxisPoint Health LLC (HGS AxisPoint Health), has received reaccreditation for its Case Management and Population Health Program accreditations. These programs are accredited by the National Committee for Quality Assurance (NCQA) for up to three year terms.
“NCQA Accreditation standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement,” said Ramesh Gopalan, Chief Executive Officer of HGS Healthcare. “NCQA Accreditation standards are purposely set high to encourage organizations to continuously enhance their quality.”
Zac Fritz, Chief Executive Officer of HGS AxisPoint Health, said, “NCQA accreditation standards provide a framework to help health plans align future initiatives with issues that are front and center for their customers and states. We are excited to be executing on these accredited programs with our clients and prospects.”
NCQA Accreditation standards are developed with input from various stakeholders and resources: health plans, population health management industry leaders and organizations, an expert panel and standing committees. NCQA Accreditation standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement.
“Case Management Accreditation moves us closer to measuring quality across population health management initiatives,” said Margaret E. O’Kane, President, NCQA. “Not only does it add value to existing quality improvement efforts; it also demonstrates an organization’s commitment to the highest degree of improving the quality of their patients’ care.”
The Case Management Accreditation Program is organized into ten standards:
1. Program Description: The organization uses up-to-date evidence-based information to develop its case management program, and regularly updates the program with relevant findings and information.
2. Patient Identification and Assessment: The organization systematically identifies patients who qualify for its programs.
3. Care Planning: The organization coordinates services for patients through the development of individualized care plans.
4. Care Monitoring: The organization has systems in place to support case management activities and monitors individualized care plans.
5. Care Transitions: The organization has a process to manage care transitions, identify problems that could cause care transitions and prevent unplanned transitions, when possible.
6. Measurement and Quality Improvement: At least annually, the organization measures patient satisfaction, program effectiveness and participation rates.
7. Staffing, Training and Verification: The organization defines staffing needs, provides staff with ongoing training and oversight and verifies health care staff credentials.
8. Rights and Responsibilities: The organization communicates its commitment to the rights of patients and its expectations of patients’ responsibilities.
9. Privacy, Security and Confidentiality Procedures: The organization has procedures to protect the privacy of patients’ health information.
10. Delegation: The organization provides written documentation of each delegated arrangement.
Added O’Kane about the Population Health Program Accreditation, “The Population Health Management programs moves us in greater alignment with the increased focus on person-centered population health management. Not only does it add value to existing quality improvement efforts; it also demonstrates an organization’s highest level of commitment to improving the quality of care that meets people’s needs.”
The Population Health Program Accreditation is organized into 9 standards:
1. Program Description: The organization describes its population health management program, including its evidence base, and reviews and adopts new findings that are relevant to its program as they become available, as appropriate.
2. Data Integration: The organization collects and integrates data sources to conduct population health management functions.
3. Population Assessment: The organization conducts a population assessment to identify needs and characteristics of the population.
4. Population Segmentation: The organization segments or stratifies the population into actionable categories for intervention.
5. Targeted Interventions: The organization provides targeted interventions based on the individual’s needs.
6. Practitioner Support: The organization involves practitioners by providing them with information.
7. Measurement and Quality Improvement: The organization evaluates the effectiveness of the population health programs.
8. Individuals’ Rights and Responsibilities: The organization communicates the individual’s rights and responsibilities.
9. Delegation of Population Health Management: The organization carefully monitors functions performed by other organizations.
About NCQA
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more-informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.
About HGS Healthcare
HGS Healthcare combines technology-powered services with decades of healthcare domain expertise to drive positive outcomes. We optimize the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. HGS Healthcare has more than 21,000 employees across 5 countries and revenues of US$400 million.
Visit www.HGShealthcare.com to learn how HGS Healthcare can help make your business more competitive.
About HGS AxisPoint Health
HGS AxisPoint Health is a whole-person care management services company focused on identifying and addressing the root causes of behaviors that worsen physical health. APH reduces medical costs, improves regulatory compliance, and increases member satisfaction. Trust and relationship building are at the core of our approach, which combines industry-leading predictive analytics, a proprietary rules-engine, specialized clinical content, and passionate clinicians who care about the members’ success. The company is fully accredited by NCQA for Population Health and Case Management.
Visit https://AxisPointHealth.com to learn how HGS AxisPoint Health can reduce your cost of care while making your health plan compliant.
