Preparation for an NCQA accreditation or certification survey can be a struggle, but these three action items can dramatically reduce the preparation difficulties and increase an organization’s likelihood of success:

1. Provide adequate resources: The NCQA standards not only address quality improvement, but they also address a number of other areas, too. Areas such as utilization management, provider relations, marketing, informatics, member services and support must be involved. These areas must be supported by senior management and must be given the training and time to devote to the survey preparation effort.
2. You can never start too early: Many NCQA standards require an organization to demonstrate compliance over a number of years. It is advisable for an organization to start preparation activities three years prior to a survey. This will afford the organization with time to make sure that structure and processes are in place and that required measurements and improvements can be documented.
3. Engage expert help: Preparation for an NCQA survey requires expertise in NCQA subject matter and complex project management skills. Often times the day-to-day working operations within an organization are all encompassing and do not afford individuals with the time to devote to the NCQA process. If permanent staff devoted to NCQA oversight and preparation is not possible, consider investing in a NCQA consultant. A NCQA consultant can establish project plans, interpret the intent of the standards, assess compliance, participate in and coordinate preparation activities, and track time lines and milestones. If considering the use of a NCQA consultant, make sure that the consultant is an NCQA surveyor. Only an NCQA surveyor will truly understand the NCQA process, the intent of the standards, the philosophy behind NCQA accreditation and certification.

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Written by: Ellen Pauley, RN, MSB. Ellen, one of PSN’s NCQA consultants, has been an active NCQA surveyor since 1991 and helped to develop many of the NCQA Accreditation and Certification products.

PSN is an industry-leader in NCQA accreditation services.  Each of PSN’s NCQA consultants have worked as NCQA surveyors, have over 30 years of combined NCQA surveyor experience, and total more than 50 years of NCQA consulting experience.  Feel free to contact us to learn more about our NCQA accreditation services.