For managed care organizations, which pair is named as accrediting bodies?

For managed care organizations, which pair is named as accrediting bodies?

• A. NCQA - URAC
• B. TJC - DNV
• C. HFAP - NCQA
• D. URAC - HFAP

Answer: (A)

Accreditation in managed care centers on external validation of both quality of care and administrative processes. The two most commonly recognized accrediting bodies for managed care organizations are NCQA and URAC. NCQA assesses health plans and related structures, focusing on performance metrics, member access, and program integrity through standards like HEDIS and CAHPS, giving plans a credible signal of quality to employers, purchasers, and consumers. URAC complements this by evaluating organizational processes, governance, patient protections, and continuous quality improvement, emphasizing how a plan operates to keep members safe and well-informed. Because managed care organizations typically pursue accreditation from these two bodies to demonstrate quality and accountability, they are the standard pairing referenced. Other accrediting organizations exist (such as The Joint Commission or DNV GL) but they are more often tied to hospital or facility accreditation rather than the managed care organization as a whole, and HFAP similarly relates to facility-focused accreditation.

Accreditation in managed care centers on external validation of both quality of care and administrative processes. The two most commonly recognized accrediting bodies for managed care organizations are NCQA and URAC. NCQA assesses health plans and related structures, focusing on performance metrics, member access, and program integrity through standards like HEDIS and CAHPS, giving plans a credible signal of quality to employers, purchasers, and consumers. URAC complements this by evaluating organizational processes, governance, patient protections, and continuous quality improvement, emphasizing how a plan operates to keep members safe and well-informed. Because managed care organizations typically pursue accreditation from these two bodies to demonstrate quality and accountability, they are the standard pairing referenced. Other accrediting organizations exist (such as The Joint Commission or DNV GL) but they are more often tied to hospital or facility accreditation rather than the managed care organization as a whole, and HFAP similarly relates to facility-focused accreditation.