What are the NCQA standards?
NCQA standards are essentially a roadmap for provider improvement. These standards are used to perform analysis and align improvement actions with what is most important to employers and states. NCQA standards evaluate health plans on the following criteria:
- Population Health Management
- Quality Management and Improvement
- Utilization Management
- Network Management
- Credentialing and Recredentialing
- Member Connections
- Medicaid Benefits and Services
- Members’ Rights and Responsibilities
