Question

Role of Accreditation As MCOs continue to find ways to distinguish themselves in the market place, many seek to obtain accreditation for different services and different reasons. What role does accreditation play in managed care? Why would an organization pursue accreditation? What impact does accreditation have on the administration of an MCO? references please !

Answer 1

Accreditation is the evaluation process where the healthcare organization systems, processes, and performance are examined. The major role played by the organization is regulated by the State health Departments, State insurance departments, and the U.S Department of Human and Health services. Managed care play accreditation role in Governmental public services and the non-governmental services such as Joint Commision Accreditation, National Committee for Quality Assurance.

Accreditation helps to perform excellence in the Managed care services. It promotes best practices and quality improvement. It reviews the Organization programme such as Medicare and Medicaid. MCOs maintain Standards of the Organization through the accreditated Standards. It complies with the insurance market. Accreditated tool assesses the performance of the organization continuously.

The Managed Care services are extremely satisfied by the Health members. It addresses the healthcare issues and the healthcare reform. It promotes the best practices and quality improvement. Managed care Organization offering incentives based on the patient satisfaction. The providers are also accreditated by the MCOs. Some states are Medicare certified For serving Managed care contracts.