Policy & Regulation News

New NCQA Population Health Programs Push Patient-Centered Care

The programs will support organizations' population health efforts and drive patient-centered care, NCQA says.

population health patient-centered care

Source: Thinkstock

By Sara Heath

- Patient-centered care and population health management are emerging as two key priorities for the National Committee for Quality Assurance (NCQA) as the body announced two new population health programs.

The organization has unveiled the Population Health Program Accreditation and the Population Health Management Prevalidation, each with the intention to assess and improve population health efforts at participating healthcare organizations.

The programs come as a part of NCQA’s efforts to improve patient-centered care and drive better complex care management, said Margaret E. O’Kane, the president of NCQA.

“The Population Health Management Programs suite moves us into greater alignment with the focus on person-centered population health management,” O’Kane said in a statement. “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 specifically will assess how an organization applies population health concepts to certain populations. Ideally, this will help organizations engage in evidence-based care, operate more efficiently, and manage complex care needs for patients.

Additionally, it will assist organizations working to manage high-risk patients and prevent high-cost health events.

The individual evaluation areas include:

  • Data integration
  • Population assessment
  • Population segmentation
  • Targeted interventions
  • Practitioner support
  • Measurement and quality improvement

The benefits to completing this program will include delivering more patient-centered care, NCQA said. By meeting criteria, organizations should be able to deliver tailored and individualized care plans to patients.

Additionally, organizations will likely operate more efficiently and deliver higher-value care. Organizations will also be better equipped to meet value-based contracting standards with payers and employers because those organizations will be delivering higher-quality care to patients.

The Population Health Management Prevalidation program looks at how organizations leverage health IT to meet their health improvement goals. This will increase an organization’s value in the accreditation process and ensure that health IT meets population health management standards.

The evaluation areas will include:

  • Data integration
  • Population assessment
  • Segmentation
  • Case management systems

The benefits to the Prevalidation program include easing organizations’ participation in other NCQA accreditation programs, the organization said. This will streamline paperwork processes, give organizations advantages with certain vendors, and grant access to certain NCQA guiding materials, the organization said. This is also an area that organizations can advertise, NCQA advised.

NCQA has been giving increasing attention to patient-centered care efforts. Earlier this year, the organization announced a project to test patient-centered measures in value-based care.

With $2.1 million in funding, NCQA partnered with Kaiser Permanente Northwest, Priority Health, Community Health Plan of Washington, and MedStar Good Samaritan Hospital Center for Successful Aging to understand how patient-centered measures would impact value-based care model success.

“Most everyone agrees individuals’ priorities and health goals should guide their care,” O’Kane said in a statement. “Are people more concerned about lowering their A1C levels or walking to the corner market? Would they rather see improvement in BMI or be able to spend more time with a loved one?”

“Existing quality measures do not effectively evaluate what is most important to people, particularly older adults with complex care needs, and we hope to change that,” she added.

Patient-centered measures may be more likely to yield value-based care success because they are more motivating, NCQA and its partner organizations hypothesized. When a patient’s quality of and satisfaction with life is on the line, they may be more likely to engage in healthy behaviors.

NCQA has not yet released results from this test, but it has boasted the endeavor as part of its overall efforts to improve patient-centered care.


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