Anita McCreavy

Why Your Organization Should Consider Accreditation or Certification Status

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Many organizations find accreditation and certifications to be a requirement in a standard book of business. They provide a roadmap for your organization to be clinically sound, quality driven, and integrated. These accreditations assist organizations in demonstrating to their customer’s compliance with regulatory standards and a fundamentally sound structure.

If you are considering an initial or renewal of your accreditation, ensure all aspects of the process are addressed to achieve success at the highest level. Gorman Health Group’s (GHG’s) clinical team of RN professionals is ready to support this in-depth project:

  1. All of these accreditation programs require a team effort. Some accreditations require a robust team and a project manager to ensure all the standards are prepared and met before the formal review.
  2. Preparing for these accreditations and certifications takes time and cannot be managed off the corner of your desk. You will need to have support, tools, and helping hands to guide you through the process.
  3. Many accreditations have look-back periods which require the organization to examine the applicable standards and sample cases to ensure compliance. When necessary, GHG can assist in the development of corrective actions to ensure your organization meets the needs of all standards, contracts, and organizational goals.
  4. GHG’s clinical team is experienced in preparing organizations for accreditation and keeping within the scope of other federal, state, or contractual requirements. Additionally, GHG takes into consideration when an organization is maintaining multiple accreditations (e.g., NCQA and URAC) and can assist in the necessary crosswalks. Some popular organizations and programs may include, but are not limited to, the following:

National Committee for Quality Assurance (NCQA)

Healthcare Accreditation Programs

  • Accountable Care Organizations
  • Health Plan Accreditation
  • Wellness & Health Promotion
  • Case Management
  • Managed Behavioral Health Organizations
  • Disease Management (DM)
  • Accreditation User Groups

Certification 

  • Credentials Verification Organization
  • DM
  • Health Information Products
  • Physician and Hospital Quality
  • Wellness & Health Promotion

Distinction

  • Multicultural Health Care
  • Patient-Centered Medical Home (PCMH)
  • Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Distinction

Recognition

  • Diabetes Recognition Program
  • Heart/Stroke Recognition Program
  • PCMH
  • Patient-Centered Specialty Practice
  • Government Recognition Initiative

URAC

 

Accreditation Programs

  • Accountable Care Accreditation
  • Case Management Accreditation with Measures
  • Clinical Integration Accreditation
  • Community Pharmacy Accreditation
  • Credentials Verification Organization
  • Dental Plan Accreditation
  • Disease Management
  • Drug Therapy Management Accreditation
  • Health Content Provider
  • Health and Dental Plan Programs
  • Healthcare Management Programs
  • Health Network
  • Healthcare Operations Programs
  • Health Plan with Health Insurance Marketplace Accreditation
  • Health Web Site
  • Health Utilization Management
  • Independent Review Organization Accreditation
  • Mail Service Pharmacy Accreditation
  • Medicare Advantage Accreditation
  • PCMH Certification
  • Pharmacy Benefit Management Accreditation
  • Pharmacy Quality Management Programs
  • Provider Integration & Coordination Programs
  • Specialty Pharmacy Accreditation
  • Telehealth Accreditation
  • Workers Compensation and Property & Casualty Pharmacy Benefit Management Accreditation
  • Worker’ Compensation Utilization Management Accreditation

Measurement

  • URAC Quality Domains
  • Performance Measurement
  • Measures Process Evaluation

AccreditNet

Whether your organization is preparing for accreditation or certification or just wants to follow accreditation standards for optimal quality healthcare, the GHG clinical team can help you reach your goals. The GHG team has the applicable tools to conduct formal assessments, identify care gaps, and create a work plan to drive and execute organizational preparation toward program accreditation or certification. Please contact us so we can discuss how GHG can partner with you to get this done.

 

Resources:

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Anita McCreavy

About Anita McCreavy

Anita McCreavy is a Senior Consultant at Gorman Health Group (GHG). In this role, she provides expertise to health plans regarding quality improvement, the Centers for Medicare & Medicaid Services (CMS) Quality Bonus Program, and Star Ratings improvement. Anita brings GHG clients more than 30 years of experience in the healthcare industry. Her areas of experience include medical necessity compliance, managed care, disease management, quality management and improvement, and clinical practice. Read more

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