NCQA’s Health Outcomes Accreditation (HOA) program uniquely equips participating organizations to leverage data-driven insights to enhance member access to culturally responsive, quality care. The Centene Corporation Corporate HOA Team has partnered with over 30 health plans across Medicaid and Exchange lines of business to achieve and maintain HOA Accreditation status and monitor the impact of their HOA programming. The Centene HOA Team has designed and applied a “Cohort Model” for maintaining HOA compliance across the organization. Presenters from the HOA Team and participating Centene health plans will discuss the benefits and challenges of utilizing this model, including improved readiness, reduction in duplicative efforts, enhanced collaboration, and delivering customized guidance. Discussion will also cover the associated challenges, such as balancing standardized processes with health plans’ local contexts. Presenters will also highlight opportunities for translating this generalizable model to other managed care organizations and health insurance environments.

Key Takeaways

• Managed care organizations that manage or support accreditation programs for multiple health plans can leverage a Cohort Model to streamline efforts and maintain healthy accreditation readiness across their organization.
• Health plans that participate in Cohort Models can collaborate with one another, offering opportunities to learn from other health plans’ successes and failures, partner on health outcomes initiatives, and identify best practices. 
• The Centene HOA Cohort Model should be evaluated based on its ability to prepare health plans for successful accreditation, but also for goals like successful health plan collaboration and HEDIS and CAHPS measure improvement.