Which two organizations are cited as accreditation bodies for Managed Care Organizations (MCOs)?

Which two organizations are cited as accreditation bodies for Managed Care Organizations (MCOs)?

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

Answer: (A)

Accreditation for Managed Care Organizations comes from quality organizations that evaluate how well a plan manages care, monitors performance, and protects members. The two organizations typically cited for accrediting MCOs are NCQA (National Committee for Quality Assurance) and URAC. NCQA sets comprehensive standards for managed care plans, focusing on quality measurement, performance improvement, access to care, and patient protections. URAC provides accreditation with an emphasis on consumer protection, care quality, utilization management, and information governance. The other organizations listed are more associated with accrediting hospitals or broader health care facilities rather than certifying managed care plans, so NCQA and URAC are the correct pair for MCO accreditation.

Accreditation for Managed Care Organizations comes from quality organizations that evaluate how well a plan manages care, monitors performance, and protects members. The two organizations typically cited for accrediting MCOs are NCQA (National Committee for Quality Assurance) and URAC. NCQA sets comprehensive standards for managed care plans, focusing on quality measurement, performance improvement, access to care, and patient protections. URAC provides accreditation with an emphasis on consumer protection, care quality, utilization management, and information governance. The other organizations listed are more associated with accrediting hospitals or broader health care facilities rather than certifying managed care plans, so NCQA and URAC are the correct pair for MCO accreditation.