2016 Medicaid Managed Care Toolkit

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The 11th annual release of NCQA's Medicaid Managed Care Toolkit provides states and their contracted quality partners with a guide to making the most of accreditation and the HEDIS® and CAHPS® reporting NCQA requires of plans we accredit.

The toolkit explains how states can take advantage of the federal authority to streamline oversight of Medicaid managed care plans through the use of private Accreditation for health plans. Using Accreditation for oversight reduces unnecessary duplication in the oversight process. The toolkit highlights the areas where NCQA's evaluation standards and performance measures can be used to supplement and, when considered applicable, serve in lieu of relevant Medicaid requirements and complement the mandatory EQRO activities.