Neighborhood Earns Highest Level of Accreditation Status For 15th Consecutive Year

After a comprehensive evaluation, NCQA awards an “Excellent” status, placing Neighborhood in the top 4% of Medicaid health plans nationwide

 

September 22, 2016 (Smithfield) – Neighborhood Health Plan of Rhode Island today proudly announced it has once again been awarded the Medicaid accreditation status of “Excellent” by the National Committee for Quality Assurance (NCQA).  

In 2001, Neighborhood became the first Federally Qualified Health Center-based health plan in the country whose Medicaid managed care accreditation status was determined to be “Excellent” by NCQA; Neighborhood has retained that status every year since. Throughout that time, Neighborhood has also maintained a close partnership with the state’s Community Health Centers, which provide a crucial link to health care for tens of thousands of Rhode Islanders. The “Excellent” designation is reserved for health plans that have well-established programs for service, and that maintain high levels of quality throughout their delivery systems in an effort to constantly improve the health care of their members.

In 2016, only eight out of 152 accredited Medicaid managed care plans nationwide received this status.  

"Achieving an 'Excellent' accreditation from NCQA has become increasingly challenging for health plans in recent years, to say nothing of being able to retain that designation year after year," said Peter Marino, Neighborhood's President and CEO. "That Neighborhood has been able to perform so consistently well speaks to the dedication, determination, and skill of our employees and our community partners. We remain focused on our members and on our mission to serve."

On its website, NCQA explains “it awards its highest accreditation status of Excellent to organizations with programs for service and clinical quality that meet or exceed rigorous requirements for consumer protection and quality improvement.”

Neighborhood’s accreditation status reflects the non-profit insurer’s exceptionally strong performance on its most recent rounds of evaluation. For example, Neighborhood’s scores on this year’s CAHPS® (Consumer Assessment of Healthcare Providers and Systems) survey show that Neighborhood’s members are pleased with the quality of the attention they receive from Neighborhood; members also praise Neighborhood’s ever-increasing provider network. Additionally, the CAHPS survey revealed that more than 97% of Neighborhood members would recommend the health plan to their family and friends.

Further, Neighborhood’s latest HEDIS (Healthcare Effectiveness Data and Information Set) results are in the highest possible range of national performance. The HEDIS results reveal our members’ high levels of satisfaction with the Neighborhood’s customer service department, claims processing, and the ability to get needed care in a timely manner.

"Neighborhood has experienced tremendous growth over the past three years," Marino continued. "Even in the face of an ever-changing and increasingly competitive health care landscape, Neighborhood has remained true to its goal of working towards a Rhode Island where everyone has access to high-quality, affordable health care. We are proud to have once again earned NCQA’s highest rating and we look forward to working with our partners to continue this great work."

About Neighborhood:
Neighborhood Health Plan of Rhode Island is a non-profit HMO that was founded in 1993 in partnership with Rhode Island’s Community Health Centers. Currently serving more than 188,000 members, Neighborhood has doubled in membership, revenue and staff since November 2013 as a result of the Affordable Care Act and decisions state leaders have made to extend coverage to more Rhode Islanders. In January 2014, Neighborhood extended its service, benefits and value to individuals and businesses through HealthSource RI – the state’s health insurance exchange; Neighborhood serves 49% the RI exchange market.  Neighborhood has been rated by National Committee for Quality Assurance (NCQA) as one of the Top 10 Medicaid health plans in America every single year since ratings began twelve years ago – one of only two organizations in the country to have this distinction. 

About the National Committee for Quality Assurance:
The National Committee for Quality Assurance (NCQA) is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral healthcare organizations, preferred provider organizations, new health plans, physician organizations, credentials verification organizations, disease management programs and other health-related programs. NCQA is governed by a Board of Directors that includes employers, consumers, health plans, quality experts, policy makers and representatives from organized medicine. It also recognizes clinicians and practices in key areas of performance. NCQA’s Web site (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).