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How can you stay current with changes in managed care accreditation?

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Managed care accreditation is a process of evaluating the quality and performance of health plans, providers, and organizations that deliver managed care services. Accreditation standards are constantly updated to reflect the changing needs and expectations of consumers, regulators, and payers. As a healthcare manager, you need to stay current with these changes to ensure compliance, competitiveness, and credibility in the managed care market. Here are some tips on how to do that.

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1 Subscribe to accreditation newsletters and alerts

One of the easiest ways to stay current with changes in managed care accreditation is to subscribe to newsletters and alerts from the accreditation bodies, such as the National Committee for Quality Assurance (NCQA), the Utilization Review Accreditation Commission (URAC), and the Accreditation Association for Ambulatory Health Care (AAAHC). These sources will inform you of the latest updates, revisions, and deadlines for accreditation standards, criteria, and measures. You can also sign up for webinars, podcasts, and online courses that offer more in-depth guidance and best practices.

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Pernell Jones, FACHE

Value creator, delivering bespoke guidance at the intersection of technology and healthcare. Adjunct professor. Father.
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America’s Physician Groups (formerly California Association of Physician Groups) and the Integrated Healthcare Association encourages managed care organizations to publish results from their innovative care programs and submit overall performance data. This typically lends itself to industry benchmarking and fosters performance improvement to the system as a whole. Those who perform well are recognized. It also assists these organizations in contracting efforts.

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Kimon Bekelis

Chair of the Neuroscience Service Line for CH, Chairman of Neurointerventional Services at CH, Co-founder of Ikona Health, Assistant Professor at TDI
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Accreditation is crucial to benchmark institutional performance against national standards. Standards, criteria and measures are always evolving and tracking them is important to ensure best practices.

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2 Join professional associations and networks

Another way to stay current with changes in managed care accreditation is to join professional associations and networks that focus on healthcare quality, management, and innovation. For example, you can become a member of the American College of Healthcare Executives (ACHE), the Healthcare Financial Management Association (HFMA), or the American Health Quality Association (AHQA). These organizations will provide you with access to publications, events, forums, and peer groups that can help you learn from experts and peers in the field.

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Dr. Fatma Matano

Doctor of Medicine| Migration Health Physician| Clinical Researcher| Strategic Leadership
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Very true, these organizations are most of the times well informed and might help you keep up but I find the best way is to be connected or linked with the care accreditation organization itself through their website or social media pages which they regularly update. One can as well make an effort of keeping up with their webinars, conferences etc. to receive first hand information rather than depending on others to help keep you updated.

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Dr. Shane Ryan Apperley ???????? DMS, MSc., PGCert., FRSPH, PA-R

Associate Professor, Franklin Pierce University ? Visiting Professor, University of the West of England (UWE) Bristol ? Physician Associate ? Doctor of Medical Science ? Veteran ? Scholar ? Husband ? Father
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Not only can you join one or more of the organisations listed, you can follow (and otherwise engage with) these groups on LinkedIn. I personally get a lot of my accreditation updates RE. the PA profession (both in the U.S. and the U.K.) through my LinkedIn network.

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3 Monitor industry trends and benchmarks

A third way to stay current with changes in managed care accreditation is to monitor industry trends and benchmarks that affect the accreditation standards and expectations. For example, you can follow the reports and recommendations from the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), or the Leapfrog Group. These sources will give you insights into the emerging issues, challenges, and opportunities in healthcare quality, safety, and efficiency. You can also compare your performance with other accredited organizations and identify areas for improvement.

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Kimon Bekelis

Chair of the Neuroscience Service Line for CH, Chairman of Neurointerventional Services at CH, Co-founder of Ikona Health, Assistant Professor at TDI
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The Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), or the Leapfrog Group are the main organizations behind standard creation and adherence. Monitoring their evolving standards allows institutions to stay up to date and offer safe and effective care.

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Dr Meghanath Yenni

Consultant Physician @ Medicover Hospitals | Internal Medicine. Avid Writer on Medical,Social and Geo-political issues. Medico-Legal Expert
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Health care is ever evolving and there is never a scope of compromise or complacency in health care.Being outdated or out of touch not just puts us behind in the race but places us on the wrong foot.Like educational institutions, health care organisations too have accreditation bodies and standards that should be upheld and in some states have been made mandatory to provide clinical care. These accreditation guidelines and framework changes from time to time so that healthcare institutions evolve with time and implement the industry's best procedures which ultimately benefit patient care.Every health care worker should be aware and follow these guidelines in their practice and further support the cause for world class clinical care.

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4 Engage your staff and stakeholders

A fourth way to stay current with changes in managed care accreditation is to engage your staff and stakeholders in the accreditation process and activities. For example, you can create a multidisciplinary accreditation team that is responsible for reviewing, implementing, and evaluating the accreditation standards and requirements. You can also solicit feedback and suggestions from your staff, patients, partners, and regulators on how to improve your quality and performance. By involving your staff and stakeholders, you can foster a culture of continuous learning and improvement.

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Kimon Bekelis

Chair of the Neuroscience Service Line for CH, Chairman of Neurointerventional Services at CH, Co-founder of Ikona Health, Assistant Professor at TDI
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Effective adherence to standards requires institutional commitment not only from administration but from all the staff. That requires culture change across the institution and participation of the staff to these initiatives from the ground up. A culture of learning and continuous quality improvement is key for success.

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5 Seek external consultation and support

A fifth way to stay current with changes in managed care accreditation is to seek external consultation and support from experts and consultants who specialize in accreditation preparation and compliance. For example, you can hire a consultant who can conduct a mock survey, identify gaps and risks, and provide recommendations and action plans. You can also partner with a vendor who can offer software, tools, and services that can simplify and streamline your accreditation documentation and reporting. By seeking external consultation and support, you can benefit from the knowledge and experience of professionals who can help you achieve and maintain accreditation.

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Kimon Bekelis

Chair of the Neuroscience Service Line for CH, Chairman of Neurointerventional Services at CH, Co-founder of Ikona Health, Assistant Professor at TDI
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External consultation is important to ensure that the institutional efforts for benchmarking are in the right direction. In the setting of ever evolving standards it is important to receive feedback and identify deficiencies that can be corrected. This is crucial immediately before surveys by accreditation organizations.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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How can you stay current with changes in managed care accreditation?

1

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3

4

5

6

1 Subscribe to accreditation newsletters and alerts

2 Join professional associations and networks

3 Monitor industry trends and benchmarks

4 Engage your staff and stakeholders

5 Seek external consultation and support

6 Here’s what else to consider

Healthcare Management

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How can you stay current with changes in managed care accreditation?

1

2

3

4

5

6

1 Subscribe to accreditation newsletters and alerts

2 Join professional associations and networks

3 Monitor industry trends and benchmarks

4 Engage your staff and stakeholders

5 Seek external consultation and support

6 Here’s what else to consider

Healthcare Management

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