The National Committee for Quality Assurance (NCQA) has introduced new accreditation standards aimed at enhancing the quality and regulatory compliance of virtual care programs. These standards are designed to align with value-based care contracts and improve overall virtual care delivery.
The development of these new standards was informed by insights from NCQA’s Virtual Care Accreditation Pilot Program, which gathered feedback from healthcare organizations, industry discussions, market research, and public comments. This comprehensive approach helped shape the standards to ensure they are relevant and effective.
NCQA’s new accreditation includes two main categories: Virtual Care Delivery and Virtual Care Delivery Oversight. The first is for organizations that provide virtual primary and urgent care services, either as a virtual-first or hybrid model. The second is for entities that oversee virtual care delivery without providing direct care. Organizations can pursue one or both accreditations, which will involve annual reporting to help continuously improve their virtual care programs.
The accreditation process offers several benefits, including flexibility tailored to an organization’s specific needs and goals, personalized service from an assigned NCQA representative, user-friendly reporting with minimized paperwork, and alignment with ongoing changes in healthcare.
Currently, NCQA has released the first two modules focusing on primary and urgent care, with additional modules planned for the future. An informational webinar, Virtual Care Accreditation 101, is scheduled for September 24 at 1 p.m. ET to further assist organizations in navigating the new accreditation process.
The introduction of these standards comes in response to the significant rise in virtual care during the COVID-19 pandemic. Recognizing the growing importance of telehealth, NCQA updated its Healthcare Effectiveness Data and Information Set (HEDIS) measures in 2020 to better reflect the role of telehealth in the healthcare system.
However, challenges remain. Matt Wolf, a senior healthcare analyst at consulting firm RSM US, highlighted that despite the enduring role of telehealth, regulatory and reimbursement structures could hinder progress. He noted that the fragmented regulatory landscape and local payment structures could impede the potential of virtual care, suggesting that reform and improved incentives are needed to maximize its benefits.
In announcing the new accreditation standards, Peggy O’Kane, NCQA’s president, emphasized the importance of high-quality and equitable virtual care. She stated, “Healthcare delivery has undergone significant transformation with the rapid adoption of virtual care, and while accessible health care is important, it must also be of high quality and equitable across the care continuum.” This underscores NCQA’s commitment to ensuring that virtual care not only expands access but also meets rigorous standards of quality.