NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
Grand Canyon University NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?-Step-By-Step Guide
This guide will demonstrate how to complete the Grand Canyon University NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)? assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
Whether one passes or fails an academic assignment such as the Grand Canyon University NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)? depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
The introduction for the Grand Canyon University NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)? is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
After the introduction, move into the main part of the NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)? assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
NUR 621 Topic 5 DQ 1
KNOWLEDGE CHECK
What is the role of accreditation on quality? Provide one example to support your discussion.
I think accreditation helps to improve the quality of services provided in the healthcare sector. Research has showed that healthcare facilities that are accredited provide a higher quality of care than those that are not accredited, which result in better patient outcomes. If a healthcare institution is not accredited, it does not have to maintain any standards of healthcare, because it does not have to any accrediting agency to critique its policy or procedures to a certain standard. As the saying goes” if there is no accountability there is no responsibility”.
Reference:
Akmal, A., Podgorodnichenko, N., Foote, J., Greatbanks, R., Stokes, T., & Gauld, R. (2021). Why is Quality Improvement so Challenging? A Viable Systems Model Perspective to Understand the Frustrations of Healthcare Quality Improvement Managers. Health Policy, 125(5), 658–664. https://doi.org/10.1016/j.healthpol.2021.03.015
Sample Answer 2 for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
Accountable Care Organization (ACO) consists of networks of providers that are rewarded financially if they can slow the growth in their patients’ healthcare spending while maintaining or improving the quality of care they deliver. For ACOs to be a success, there must be a collaboration of care. The goal of the ACOs is to provide well-coordinated, cost-effective care when clients need it. Under the Shared Savings Program, ACOs must meet several eligibility requirements, including providing certification to the Centers for Medicare and Medicaid Services (CMS) and their ACO application to be considered for and participate in this saving program (Strategic Management Services, 2022).
The National Committee for Quality Assurance (NCQA) is a private non-profit organization dedicated to improving healthcare quality (NCQA, 2022). The NCQA’s mission is to improve health care quality with the vision of better healthcare, better choices, and better health (NCQA, 2022). The NCQA developed quality standards and performance measures for a broad range of healthcare entities, and these tools helped organizations and individuals to identify opportunities for improvement (NCQA, 2022). The NCQA Health Plan Accreditation help to meet the goal of a plan that supports care that keeps members at an optimum level of health while controlling costs and meeting government and purchaser requirements (NCQA, 2021). Another accrediting body that helps to improve the quality of care is the Utilization Review Accreditation Commission (URAC). The URAC is one of America’s most prestigious accrediting organizations and non-profit accreditation entities that helps to improve the quality of care (URAC, 2022). The URAC’s renowned accreditation and certification programs set the highest standards in quality and safety (URAC, 2022).
Accreditation is essential in healthcare for accountability and to meet standards. Accreditation helps to improve healthcare quality and adherence (URAC, 2022). Health plans may choose one accrediting organization over another because of costs, accreditation process, recognition, and the different requirements needed to be accredited. Despite the choice of the accrediting body, the aim is to ensure high-quality care.
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References
National Committee for Quality Assurance. (2021). Health plan accreditation. https://www.ncqa.org/programs/healthplans/health-plan-accreditation-hpa/
National Committee for Quality Assurance. (2022). About the NCQA. https://www.ncqa.org/about-ncqa/
Strategic Management Services. (2022). Accountable care organizations: ACO final rule summary.
Utilization Review Accreditation Commission. (2022). About the URAC. https://www.urac.org/about/
Sample Answer 2 for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
Accreditation agencies are impartial organizations that oversee and evaluate the functioning of healthcare organizations to ensure they meet the pre-established performance standards. The accreditation agencies set quality standards and benchmarks to strengthen the organizations’ goals to deliver high-quality patient care. In addition, they oversee the functioning of organizations and physicians to evaluate their performance against the pre-established quality standards. With the paradigm shift from treatment and cure to prevention, health care organizations focus more on continuous quality improvement to promote positive patient outcomes. National Committee for Quality Assurance (NCQA) plays an accreditation role to organizations that incorporate medical groups, physician networks, and health plans such as PPOs and HMOs (Richter & Beauvais, 2018). It utilizes accountability, measurements, and transparency to identify the top healthcare performers and compel improvement. The private sector and the government clients seek the services of NCQA through grants and contracts to measure quality and provide the necessary improvements. NCQA focuses on HEDIS (Healthcare Effectiveness Data and Information Set) in addition to recognition and certification programs.
References
Richter, J. P., & Beauvais, B. (2018). Quality indicators associated with the level of NCQA accreditation. American Journal of Medical Quality, 33(1), 43–49. https://doi.org/10.1177/1062860617702963.
Denver, R. C. (2011). Accreditation to approve health plans and providers. National Conference of State Legislatures. https://www.ncsl.org/documents/health/HRHealthPlans.pdf.
Payne, J. (2018). A commitment to quality care: URAC accreditation for CA SB1160 and beyond. Mitchell. https://www.mitchell.com/insights/workers-comp/articles/commitment-quality-care-urac-accreditation-ca-sb1160-and-beyond.
Sample Answer 3 for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
NCQA (National Committee for Quality Assurance) uses measurement, transparency, and accountability to highlight top performers and drive improvement. It began early in 1990 by measuring and then accrediting health plans. NCQA’s mission has grown to measure the quality of medical providers and practices. Most NCQA employees work on (Healthcare Effectiveness Data and Information Set) HEDIS and accreditation, certification, and recognition programs. Government and private sector clients hire it through contracts and grants to help measure and improve quality. Accreditation is awarded for three years, and certification is awarded for two years. NCQA accredits organizations ranging from health plans including HMOs and PPOs to physician networks and medical groups (National Committee for Quality Assurance, 2022). The (National Committee for Quality Assurance) NCQA requires MCOs (Managed Care Organizations) to report quality indicators and to address concerns about under-care as part of their accreditation requirements. The NCQA uses the (Healthcare Effectiveness Data and Information Set) HEDIS for quality reporting by HMOs and other health plans. Despite the expansion of MCOs in early 1990, increased resistance to managed care by physicians limited the negotiation of HMO contracts in many communities. Consumers and some employers also became resistant to taking part in managed care plans (Penner, 2016).
URAC (Utilization Review Accreditation Commission) is an independent, nonprofit accreditation agency based in Washington, D.C. whose mission is to advance healthcare quality through leadership, accreditation, measurement, and innovation. URAC was founded in 1990 as a third-party healthcare quality validator. URAC uses evidence-based measures and develops standards through inclusive engagement with a broad range of stakeholders committed to improving healthcare quality. Most accreditations are awarded for three years. However, there are two programs with a two-year cycle (Health Content Provider and Health Website). URAC accredits health plan programs including dental plans, healthcare management programs, pharmacy quality management programs, and provider integration and coordination programs (Utilization Review Accreditation Commission, 2022).
Sample Answer 4 for NUR 621 What is the difference between the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC)?
The National Committee for Quality Assurance (NCQA) began in 1990 by evaluating and accrediting health plans. The NCQA focus on the highest-ranking plans as a tactics to drive change towards advancing others. Their mission has since developed to include performance of clinicians and their and practices. Their major focus is on Healthcare Effectiveness Data and Information Set (HEDIS), accreditation, certification, and recognition programs. The NCQA is often brought in as an external contractor to assist and guide organizations to evaluate and improve quality. They accredit organizations from an array of settings including health plans to Accountable Care Organizations (ACO’s) and medical groups (Intelligent Software and CVO Solutions, 2019).
The Utilization Review Accreditation Commission (URAC) also began in 1990 and is an independent, non-profit accreditation agency. Their mission was to develop healthcare quality with a focus on leadership techniques, compliance, evaluation, and new practices. URAC uses an evidence-based approach to evaluate and outline standards. They include stakeholders committed to improving healthcare quality (Intelligent Software and CVO Solutions, 2019).
While the NCQA and URAC have several differences in their approach, they both have the ultimate goal of improving healthcare quality. A health plan would select one accrediting body over the other for various reasons. The health plan might have aligning values with one over the other, specific accreditation sought after, cost, and the level of accreditation. The level of accreditation is an essential element in the process. As of Oct 2021, there are only eleven CMS-approved accrediting organizations, therefore those 11 accrediting bodies potentially hold a higher rank. Amongst these two accrediting bodies only one, the URAC is a CMS approved accrediting organization (U.S. Centers for Medicare & Medicaid Services, 2021).
References
Intelligent Software and CVO Solutions. (2019). Major accreditors: Comparison chart. https://www.intellisoftgroup.com/wp-content/uploads/2019/03/Accreditor-comparison.pdf
U.S. Centers for Medicare & Medicaid Services. (2021). CMS-approved accrediting organizations. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Accrediting-Organization-Contacts-for-Prospective-Clients-.pdf