Virginia Premier’s New “Commendable” Accreditation Status

Virginia Premier received our first accreditation from the National Committee for Quality Assurance (NCQA) in 2007. Since then, we have maintained focus on improving quality throughout the organization, especially in the areas of operational efficiencies, member satisfaction and access to care. Our efforts have paid off. Recently, NCQA recently awarded Virginia Premier a Commendable accreditation status (upgraded from Accredited), which meets VCU’s strategic goal of reaching the next accreditation level in 2018.

“The new status means we are on track to meet our ultimate accreditation goal, which is to be rated ‘Excellent’,” says Virginia Premier CEO Linda Hines. “This is vitally important because an essential part of our mission is to deliver industry-leading health care. We can’t do that unless it is also of the highest quality.”

The NCQA is a rigorous assessment of a health plan’s structure and processes, clinical quality and patient satisfaction. The three core components of the NCQA accreditation evaluation include Standards, the Healthcare Effectiveness Data and Information Set (HEDIS) Measures and Patient Satisfaction. More than 173 million people are enrolled in NCQA-accredited health plans like Virginia Premier.

Virginia Premier’s new and improved accreditation status is directly attributed to improvements in the HEDIS rates. HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service, and factors into the overall accreditation status. In 2018, Virginia Premier posted improvements over 2017 in all five triple-weighted measurements for our Medicaid members.

Member Satisfaction

In addition to improvements in HEDIS rates, Virginia Premier posted year-over-year improvement in five important measures of our Medicaid members’ satisfaction as well, including:

  • Getting care easily
  • Rating of primary-care doctor
  • Rating of specialists
  • Rating of care
  • Coordination of care

To help Virginia Premier achieve an Excellent accreditation status, the next level, Virginia Premier’s outreach staff are engaged in a Premier Population Health (PPH) Member Outreach Program, which features events to encourage Virginia Premier members to obtain the health services they need.

“The PPH events offer a fun way for our members to obtain care and for us to change adverse behaviors by eliminating barriers to care and incentivizing members,” says DeAnna James Anderson, Virginia Premier’s director of Population Health. “This helps close care gaps in a timely manner, identify opportunities for improvement in strategy and outcomes, and improve the health of the population through preventative care, outcomes management, and health promotion” she added.