Neighborhood Health again earns high level of accreditation; other R.I. insurers receive ‘excellent’ ranking

PROVIDENCE – Neighborhood Health Plan of Rhode Island announced it has again been awarded the Medicaid accreditation status of “excellent” by the National Committee for Quality Assurance, a nonprofit organization dedicated to driving improvements throughout the health care system. In 2001, Neighborhood became the first Federally Qualified Health Center-based health plan in the country whose Medicaid-managed care was ranked “excellent” by NCQA; Neighborhood reported that it has retained that status every year since.

Health plans may earn an NCQA accreditation of excellent, commendable, accredited, provisional, interim or denied, according to the NCQA website. The specific accreditation status is determined by a plan’s compliance with NCQA requirements and its performance on the Healthcare Effectiveness Data and Information Set (an NCQA tool addressing a broad range of significant health issues, such as asthma medication use, controlling high blood pressure, comprehensive diabetes care and immunization management) and on the Consumer Assessment of Healthcare Providers and Systems (an NCQA survey of patients about their health care experiences). The “excellent” designation is awarded, NCQA reported, to “programs for service and clinical quality that meet or exceed rigorous requirements for consumer protection and quality improvement.”

In Rhode Island, in addition to Neighborhood’s Medicaid health maintenance organization plan, these companies’ insurance plans, received the “excellent” designation from NCQA’s recently released Health Plan Report Card:

  • Tufts Associated Health Maintenance Organization, Inc.’s commercial combined HMO/Point of Service plan;
  • Tufts Benefit Administrators Inc.’s commercial Preferred Provider Option plan; and
  • UnitedHealthcare of New England Inc.’s Medicaid Managed Care Operations HMO.
  • But for Aetna Life Insurance Co.’s commercial combined Preferred Provider Option/Exclusive Provider Option combined plan – for which NCQA accreditation is in process – all other Rhode Island plans received the designation of either “commendable” or “accredited.” Neighborhood reported that it was one of only eight Medicaid-managed care plans – out of 152 such plans nationwide – to receive an “excellent” designation.

    - Advertisement -

    “Achieving an ‘excellent’ accreditation from NCQA has become increasingly challenging for health plans in recent years,” Peter Marino, Neighborhood’s president and chief executive officer, said in a statement. “That Neighborhood has been able to perform so consistently well speaks to the dedication, determination and skill of our employees and our community partners.”

    No posts to display