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AmeriHealth Caritas District of Columbia Awarded NCQA 3-Year Accreditation for Case Management

AmeriHealth Caritas District of Columbia, a mission-based Medicaid managed care plan serving more than 100,000 residents in the District of Columbia, has earned the National Committee for Quality Assurance’s (NCQA) 3-Year Case Management Accreditation.

AmeriHealth Caritas District of Columbia received NCQA’s 3-Year Case Management Accreditation for its complex case management program, which includes:

  • Addressing members’ needs in multiple community settings, including their homes, primary care offices and other acute care settings such as our Member Wellness Center.
  • Partnering with health care systems, including providers, community-based organizations and Core Service Agencies, to extend our reach into the community.
  • Employing clinical and non-clinical field-based associates to assist care managers with scheduling appointments, coordinating transportation and removing barriers to care.
  • Leveraging technology, such as telemedicine and text messaging, to promote member engagement and increase the coordination of care and other services.
  • Providing additional support to members with multiple complex health conditions or other special health care needs through high-touch (in-person) interactions.
  • Delivering person-centered, whole person, minimally disruptive care with the assistance of trained, culturally competent personnel.
  • Utilizing community-based case management services to provide cost-effective, high-quality care.

“Our care (case) managers make it a priority to provide person-centered care that addresses the needs of the whole person by promoting the integration of behavioral and physical health care,” said Karen Dale, market president for AmeriHealth Caritas District of Columbia. “Through member and provider engagement, we gain the necessary insight to continuously adapt to ever-changing member needs, providing care when and where the member needs it.”

In addition, AmeriHealth Caritas District of Columbia earned a Commendable Health Plan Accreditation status from NCQA this year.

NCQA accreditation standards are intended to help organizations achieve the highest level of performance possible and create an environment of continuous improvement. Earning NCQA’s Case Management Accreditation is an indication that a case management program is dedicated to care coordination, patient-centeredness and improving quality of care.

“Case Management Accreditation moves us closer to measuring quality across population health management initiatives,” said Margaret E. O’Kane, President, NCQA. “Not only does it add value to existing quality improvement efforts; it also demonstrates an organization’s commitment to the highest degree of improving the quality of their patients’ care.”

NCQA is a private, non-profit 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 is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

About AmeriHealth Caritas District of Columbia

AmeriHealth Caritas District of Columbia, a member of the AmeriHealth Caritas Family of Companies, is a Medicaid managed care health plan dedicated to helping members get care, stay well and build healthy communities. Headquartered in the District, AmeriHealth Caritas District of Columbia addresses social risk factors impacting health, leverages robust member engagement strategies to increase rates of preventive care, and utilizes programs to support health and wellness for the vulnerable populations it serves.

About AmeriHealth Caritas

AmeriHealth Caritas is part of the Independence Health Group in partnership with Blue Cross Blue Shield of Michigan. AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. Operating in 17 states and the District of Columbia, AmeriHealth Caritas serves more than 5.7 million Medicaid, Medicare and Children’s Health Insurance Program (CHIP) members through its integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience serving low-income and chronically ill populations.