Fallon Health in Worcester has received accreditation from the National Committee for Quality Assurance, highlighting its clinical quality, member experience, and performance against operational standards for its commercial, Medicaid, and exchange plans, the healthcare organization said in a Tuesday announcement.
NCQA assesses health plans for accreditation every three years and looks at several categories of criteria, including quality management and improvement, network management, utilization management, credentialing and recredentialing, population health management, and member experience, per Fallon.
The organization also looks at quality of care, how happy patients are, and efforts to improve service.
“As a mission driven organization, Fallon Health is committed to caring for those who need us most,” said Richard Burke, president and CEO of Fallon Health, in a statement. “This external benchmark speaks to the quality of the products and services we offer—and the work we do—to best serve our members.”
Fallon received 4.5 out of 5 possible stars in NCQA’s health plan ratings for 2022, ranking it among the highest commercial and Medicaid health insurance carriers in the state, according to Fallon.
