NCQA Accreditation
On July 29, 2026, the National Committee for Quality Assurance (NCQA), among the nation’s leading health care accreditation agencies, awarded the Access East (AE) Medicaid Care Management (CM) program the NCQA’s prestigious three-year accreditation for CM.
Note that we use the terms “case management” and “care management” interchangeably here, and across the AE website.
NCQA CM accreditation marks the successful completion of a voluntary multi-year review process for the AE Medicaid CM program. NCQA’s high standards encourage CM organizations like our own to continuously improve the quality of services we deliver.
CM accreditation, NCQA Founder Margaret E. O’Kane has stated, “demonstrates an organization’s commitment to the highest degree of improving the quality of (its) patients’ care.”
Ruth Craig, director of AE Medicaid CM, heartily agrees. “At Access East, we believe in excellence in care management,” she elaborated. “We treat our patients like they are our family members.
“NCQA accreditation pushes us to excel in documenting that same care, showing our providers and payors the superior care we provide to our community members.”
AE is one of fewer than 90 health care organizations nationwide to have achieved NCQA accreditation for CM.
Three-year accreditation, in particular, notes the NCQA website, recognizes “strong performance” of the key parts of NCQA’s framework for implementing evidence-based industry best practices, to ensure CM organizations like AE are:
- Developing and employing efficient, cost-effective CM processes and delivery of services
- Effectively managing patients as they move between care settings, like from hospital to home
- Using patient-centered assessments to determine patient-care needs
- Monitoring patients to track their care-goal progress
- Developing personalized, patient-centered care plans
- Protecting patient health information
The NCQA notes that it intentionally sets high standards “to encourage organizations to continuously enhance their quality” and “to help organizations achieve the highest level of performance possible, and create an environment of continuous improvement.”
Standards for CM Accreditation
Program Description
Uses up-to-date, evidence-based information to develop its CM program, and regularly updates the program with relevant findings and information.
Patient Identification and Assessment
Systematically identifies patients who qualify for its programs.
Care Planning
Coordinates services for patients through the development of individualized care plans.
Care Monitoring
Has systems in place to support CM activities, and monitors individualized care plans.
Care Transitions
Has a process to manage care transitions, identify problems that could cause care transitions and prevent unplanned transitions, when possible.
Measurement and Quality Improvement
At least annually, measures patient satisfaction, program effectiveness and participation rates.
Staffing, Training and Verification
Defines staffing needs, provides staff with ongoing training and oversight, and verifies health-care staff credentials.
Rights and Responsibilities
Communicates its commitment to the rights of patients and its expectations of patients’ responsibilities.
Privacy, Security and Confidentiality Procedures
Has procedures to protect the privacy of patients’ health information.
Delegation
Provides written documentation of each delegated arrangement.
The NCQA developed the above standards with input from researchers in the field, as well as its Case Management Expert Panel and standing committees, employers, various representatives with existing CM programs, state and federal regulators, and other experts.