2012: NCQA Updates HPA Standards to Align with ACA

25 for 25: A series of 25 blog posts marking NCQA’s 25th Anniversary

2012-2

Health care coverage wasn’t always easy to acquire, but things changed when the Patient Protection and Affordable Care Act (ACA) was passed. An encompassing piece of legislation, the ACA was intended to increase and improve three factors in health care: access, affordability and quality.

The ACA put consumers in charge of their health care by establishing state-based insurance marketplaces. Everyone can access a marketplace to choose the type of health insurance plan that works best for them.

Marketplaces opened the door to choice, but also created a lot of uncertainty. How would everyone know what the “best” plan would be, out of myriad plans?

That’s where “quality” comes in. Consumers are not entirely on their own when it comes to choosing health insurance. The ACA requires plans to be accredited and to collect quality data. To be included in the marketplace, a plan must prove it provides quality care.

NCQA was well positioned to take part in the marketplace. Its flagship product—Health Plan Accreditation (HPA)—has long been the only accreditation program that considers results of clinical quality and consumer experience measures.

Based on the success of HPA, CMS approved NCQA as an accreditor for health plans in the marketplace. As a national reviewer, NCQA is a “third party” for approving a health plan’s structure and performance. NCQA started early to make sure Health Plan Accreditation aligned with ACA requirements. With NCQA’s seal of approval, people can find plans that offer the best quality and value, not just low premiums.