Evolent Health First Organization Ever to Achieve NCQA Population Health Program Accreditation
Oct 09, 2019

The Population Health Program Accreditation is the third NCQA Accreditation Evolent has achieved in 2019, with Evolent having also earned 3-Year Accreditation in both Utilization Management and Case Management in 2019.

WASHINGTON, D.C., October 9, 2019 – Evolent Health, a company providing an integrated value-based care platform to the nation's leading providers and payers, today announced it is the first company ever to achieve Population Health Program Accreditation from the National Committee for Quality Assurance (NCQA), an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral healthcare organizations, preferred provider organizations, new health plans, physician organizations, credentials verification organizations, disease management programs and other health-related programs.  

Evolent received NCQA’s Population Health Program Accreditation with the status of Accredited–3 years for Evolent’s Complex Care, Transition Care, and five Condition Care programs:  Asthma, Coronary Artery Disease (CAD)/Hypertension, Chronic Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD) and Diabetes. The Population Health Program Accreditation is the third NCQA Accreditation Evolent has achieved in 2019, with Evolent having also earned 3-Year Accreditation in both Utilization Management and Case Management in 2019. Three years is the longest accreditation time period NCQA designates for organizations. Evolent’s Accreditations support health plan partners in achieving their Health Plan Accreditation by providing auto-credit for a number of standards.

“We are honored to be the first organization ever to achieve Population Health Program Accreditation from NCQA,” said Evolent Health Chief Executive Officer Frank Williams. “This reflects our focus on doing what’s right for the patient regardless of how they enter the health care system, and our commitment to working with payers and providers to significantly improve care quality and the care experience. I commend the NCQA for taking the step to evolve its Disease Management programs into this Population Health Program accreditation because it encourages the industry to advance the way we care for people through earlier interventions, preventive care and a view of the whole person beyond a disease state.”

“The Population Health Management program moves us in greater alignment with the increased focus on person-centered population health management,” said NCQA President Margaret E. O’Kane. “Not only does it add value to existing quality improvement efforts; it also demonstrates an organization’s highest level of commitment to improving the quality of care that meets peoples’ needs.”

NCQA awards the status of Accredited–3 years to organizations that demonstrate strong performance of the functions outlined in the standards for Population Health Program Accreditation. The Population Health Program Accreditation is organized into nine standards:

  1. Program Description: The organization describes its population health management program, including its evidence base, and reviews and adopts new findings that are relevant to its program as they become available, as appropriate.
  2. Data Integration: The organization collects and integrates data sources to conduct population health management functions.
  3. Population Assessment: The organization conducts a population assessment to identify needs and characteristics of the population.
  4. Population Segmentation: The organization segments or stratifies the population into actionable categories for intervention.
  5. Targeted Interventions: The organization provides targeted interventions based on the individual’s needs.
  6. Practitioner Support: The organization involves practitioners by providing them with information.
  7. Measurement and Quality Improvement: The organization evaluates the effectiveness of the population health programs.
  8. Individuals’ Rights and Responsibilities: The organization communicates the individual’s rights and responsibilities.
  9. Delegation of Population Health Management: The organization carefully monitors functions performed by other organizations.

NCQA Accreditation standards are developed with input from various stakeholders and resources: health plans, population health management industry leaders and organizations, an expert panel and standing committees. NCQA Accreditation standards are purposely set high to encourage organizations to continuously enhance their quality; the standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement.

For additional perspective, read our blog post, New Accreditation Signals Population Health's Coming Of Age.


About Evolent Health
Evolent Health partners with leading provider and payer organizations to achieve superior clinical and financial results in value-based care and under full-risk arrangements. With a provider heritage and over 20 years of health plan administration experience, Evolent partners with more than 35 health care organizations to actively manage care across Medicare, Medicaid, commercial and self-funded adult and pediatric populations. With the experience to drive change, Evolent confidently stands by a commitment to achieve results. For more information, visit evolenthealth.com.

About NCQA
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at ncqa.org, on Twitter@ncqa, on Facebook at facebook.com/NCQA.org and on LinkedIn at linkedin.com/company/ncqa.