The Big Five Healthcare Accreditation Organizations – Side by Side Comparison A side by side comparison of URAC, NCQA, TJC, CARF, and COA

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The Big Five Healthcare Accreditation Organizations: A Side by Side Comparison

The 5 major healthcare accreditation organizations are:

URAC – NCQA – TJC – The Joint CARF – COA – Council Utilization National Commission Commission on Review Committee for on Accreditation Accreditation Quality Accreditation Commission Assurance of Rehabilitation Facilities

Accreditation is a process by which an impartial organization will review a company’s operations to ensure that the company is conducting business in a manner that is consistent with national standards. Accreditation is a sign of quality and is an important consideration in their decision making.

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Benefits of accreditation, recognition, and certification include:

 National recognition including recognition by insurance companies as well as other third parties  May be a condition of reimbursement for certain insurers or Essential to other payers Many  Commitment to excellence in quality, accountability and Contracts  Competitive advantage  Improves risk management and risk reduction  May fulfill state regulatory requirements  Provides a framework for creating organizational structure Mark of and management  Provides opportunities for ongoing education and training Quality For  Can provide deeming status for Patients  Provides standardization and consistency for processes across the organization  May reduce liability insurance costs  Provides assurance the organization is current with healthcare regulations Ensures  Improves customer satisfaction ratings Commitment  Further ensures privacy and confidentiality of protected health information to Quality  Supports continuous quality improvement efforts

BHM Healthcare Solutions has achieved a 100% success rate for client accreditation, find out how we can assist you: Email: [email protected] Web: www.bhmpc.com Phone: 1-888-831-1171

Comparison URAC (Utilization Review NCQA (National TJC (The Joint CARF (Commission on COA (Council on Element Accreditation Committee for Quality Commission) Accreditation of Accreditation) Commission) Assurance) Rehabilitation Facilities) Website https://www.urac.org/ http://www.ncqa.org/Hom http://www.jointcommiss http://www.carf.org/Prog http://coanet.org/home/ ePage.aspx ion.org/ rams/ Logo

About URAC, an independent, The National Committee An independent, not-for- An Independent, non- The Council on nonprofit organization, is for Quality Assurance is a profit organization which profit accreditor of health Accreditation (COA) is an well-known as a leader in private, 501(c)(3) not-for- accredits and certifies and human services. international, promoting profit organization more than 19,000 independent, not-for- quality through its dedicated to improving organizations and profit, child- and family- accreditation, education health care quality. programs in the United service and behavioral and measurement States healthcare accrediting programs. organization. Inception 1980’s 1990 1951 1966 1977 Number of 600 + 40,000 + 20,000 + 6000+ 1800+ Accredited Organizations Cost Varies on the type of Varies on the type of Varies based upon Application fee $995 Application fee $750 accreditation – includes accreditation/certification number of sites and Site Visit Fee (based on Accreditation fee (based accreditation and on-site as well as number of number of visits the number of reviewers, on revenue) visit practice sites and/or per the number of days, Site Visit Fee (based on member per month number of programs number of reviewers) charges, discounts offered being surveyed, how Maintenance of for multiple accreditations many locations, where Accreditation Fee $400 / certifications – includes the programs are annually survey fee and processing provided, and the size of fee the programs Accreditation 4-6 months once the Varies based upon how 4-6 months 9-12 months for a new Generally 9-16 months Preparation Period application is received prepared the organization survey and 6-9 months from the point a decision is in terms of policies and for re-accreditation is made about procedures/processes accreditation

BHM Healthcare Solutions has achieved a 100% success rate for client accreditation, find out how we can assist you: Email: [email protected] Web: www.bhmpc.com Phone: 1-888-831-1171

Comparison URAC (Utilization Review NCQA (National TJC (The Joint CARF (Commission on COA (Council on Element Accreditation Committee for Quality Commission) Accreditation of Accreditation) Commission) Assurance) Rehabilitation Facilities) Accreditation 2-3 years 3 years for accreditation 3 years except laboratory 1 or 3 years for most 4 years except Opioid Granted 2 years for certification accreditation which is 2 accreditation except Treatment Programs 3 years for recognition years, certifications are 2 CARF-CFCC which is 5 which is 3 years years years Who do they URAC accredits many NCQA accredits TJC accreditations Health and human service Human service accredit? types of health care organizations and organizations: general, organizations organizations organizations. Some individuals ranging from psychiatric, children’s and accreditations are for the health plans including rehabilitation hospitals, entire organization, and Health Maintenance critical access hospitals, some focus on functional Organizations(HMOs) and home care organizations, areas of the organization. Preferred Provider nursing homes, Organizations(PPOs) to rehabilitation centers, physician networks, long term facilities, medical groups, and behavioral health individual physicians organizations, addictive services, ambulatory care providers, and independent or freestanding clinical laboratories Nationwide Some states also The NCQA seal is a widely CARF International COA accreditation is Acceptance "recognize" URAC recognized symbol of accreditation and accreditation provides a endorsed and recognized accreditation, meaning quality. certification is recognized visible symbol that in every state and by a that the accreditation can nationwide as a symbol of assures the public of a variety of groups be used to meet state quality that reflects an provider's commitment including national and regulatory requirements organization’s to continually enhance international human instead of separate commitment to meeting the quality of services service organizations. reporting to the state. A certain performance and programs with a few states require URAC standards. focus on the satisfaction accreditation in order for of the persons served. companies to do certain types of business.

BHM Healthcare Solutions has achieved a 100% success rate for client accreditation, find out how we can assist you: Email: [email protected] Web: www.bhmpc.com Phone: 1-888-831-1171

Comparison URAC (Utilization Review NCQA (National TJC (The Joint CARF (Commission on COA (Council on Element Accreditation Committee for Quality Commission) Accreditation of Accreditation) Commission) Assurance) Rehabilitation Facilities) Programs Accreditation Accreditation Accreditation Accreditation Accreditation Case Management Accountable Care Organizations Ambulatory Health Care Aging Services Private Organizations Disease Management Health Plan Accreditation Behavioral Health Care Behavioral Health Public Agencies Health Call Center Wellness & Health Promotion Critical Access Hospitals Business and Services Canadian Organisations Health Utilization Management Case Management Accreditation Home Care Management Network After School Programs Independent Review Managed Behavioral Healthcare Hospitals CARF-CCAC Networks Organization Comprehension Organizations International Accreditation Child and Youth Services Hague Accreditation and Independent Review New Health Plans Laboratory Services DMEPOS Approval Organization: Internal Disease Management Nursing and Rehabilitation Employment and Community Military and Family Readiness Independent Review Accreditation Center Services Programs Organization: External Accreditation Users Group Office-Based Surgery Medical Rehabilitation Child Care Expansion Project Workers’ Compensation Certification Certification One-Stop Career Center Utilization Management Credentials Verification Advanced Certification Opioid Treatment Program Wellness Organization Disease-Specific Care Vision Rehabilitation Services Claims Processing Disease Management Health Care Staffing Services Consumer Education and Certification International Certification Support Health Information Products Credentials Verification Utilization Management and Organization Credentialing Health Network Physician and Hospital Quality Health Plan Multicultural Health Care Medicare Advantage Health Accreditation Users Group Plan PCMH Content Expert Provider Credentialing Certification Health Content Provider PCMH CAHPS Distinction Health Web Site Recognition HIPAA Privacy Back Pain Recognition Program HIPAA Security Diabetes Recognition Program Drug Therapy Management Heart/Stroke Recognition Mail Service Pharmacy Program Specialty Pharmacy Physician Practice Connections Workers’ Compensation and Patient Centered Property and Casualty Pharmacy Government Recognition Benefit Management Initiative Abu Dhabi Pharmacy Benefit Special Needs Plans Structure & Management International Process Measures PCHCH Achievement Special Needs Plans Mode of Care PCHCH Auditor Certification Review Process PCHCH Toolkit In process – Patient Centered Credentialing Support Specialty Practice Recognition Certification Program Vendor Certification Core Standards

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