CHOP Accredited by NCQA as Accountable Care Organization

Published on in CHOP News

February 13, 2013 — The National Committee for Quality Assurance (NCQA) announced that The Children’s Hospital of Philadelphia (CHOP) has earned accreditation as an Accountable Care Organization (ACO). CHOP is the only children’s hospital in the country to earn accreditation and is among the first five organizations to be accredited nationally.

An ACO is a provider-based entity that strives to improve the quality of healthcare and patient experience, while simultaneously reducing healthcare costs. ACOs can be group practice providers, networks of individual practices, hospitals, provider-health plan partnerships or publicly governed entities that work with providers to arrange care.

CHOP a national leader in the movement toward accountable healthcare delivery

“This prestigious accreditation establishes CHOP as a national leader in the movement toward accountable healthcare delivery, focused on both quality and value,” said Madeline Bell, CHOP president and chief operating officer. “Years of hard work across the organization has built an infrastructure that supports quality improvements, patient-centered care and care coordination. CHOP is honored to be recognized for its efforts to meet the diverse healthcare needs of our patients.”

“By earning NCQA Accreditation, CHOP has demonstrated to payers and other purchasers that it has met challenging requirements designed to show the efficiency, integration and high quality expected of an ACO. NCQA Accreditation also shows patients and providers that CHOP is prepared to deliver on the promise of better care on all these dimensions,” said Margaret E. O’Kane, President of NCQA.

ACO accreditation process

To receive accreditation, CHOP underwent a rigorous assessment that focused on the evaluation of 14 standards and 65 elements that include: ACO structure and operations, access to needed providers, patient-centered primary care, care management, care coordination and transitions, patient rights and responsibilities and performance reporting and quality improvement.

The NCQA ACO Accreditation is voluntary and evaluates an organization’s ability to deliver coordinated, patient-centered care; to improve clinical quality; to enhance the patient experience; and to reduce costs through quality clinical practices. Being named an accredited ACO by the NCQA helps purchasers and providers identify effective partners. It also helps patients find physicians who are committed to providing the quality care they need, when they need it.

This latest recognition follows CHOP’s existing certification of 24 of its primary care practices in NCQA’s Patient-Centered Medical Home Program. The patient-centered medical home model provides comprehensive, patient-centered care; increased access to healthcare providers and services; coordinated care across the broader healthcare system, including specialty care, hospitals, home care, and community services; and a demonstrated commitment to quality improvement.

About the NCQA ACO Program

The NCQA program contains many consumer protections and aligns with consumer protection principles outlined in the National Partnership for Women & Families’ Campaign for Better Care. ACOs are generally defined as provider-based entities that aim to improve the quality of healthcare and reduce cost growth for a group of people. In order to have enough patients for quality reporting and managing financial risk, ACOs must serve at least 5,000 patients a year.