Step Three: Is Your Health Plan Accredited?

When you’re assessing your health insurance needs, don’t forget to factor in the plan’s accreditation status. For HMO or PPO plans, a stamp of approval from the leading accrediting bodies (NCQA, URAC, or JCAHO) means the plan (or hospital) has made a commitment to consumer accountability and national health care quality standards. For insurance companies, independent outside rating agencies such as A.M. Best, assigns a rating. Look for a rating of excellent or better.

NCQA
The National Committee for Quality Assurance (NCQA) is the leading accrediting body for HMO-based plans and is used by most of the nation's Fortune 500 employers, federal and state governments, and consumers to help select among competing health plans. NCQA compiles an annual report card that evaluates plans on clinical quality and member satisfaction. These report cards can often be found on your state’s Department of Insurance Web site. You can also search report cards at the NCQA Web site, located at http://www.ncqa.org/

URAC
The Utilization Review Accreditation Commission (URAC) is nationally recognized as the leading accrediting body for PPO-based plans. It audits a broad array of health care services and systems. URAC’s quality benchmarking activities cover health plans, preferred provider organizations, medical management systems, health call centers, specialty care, and Web sites that feature health content. You can find out more about the accreditation status of the plan you’re evaluating by visiting http://www.urac.org/

A.M. Best
Named after its founder Alfred M. Best, A.M. Best was founded in 1899 as a worldwide insurance-rating and information agency. It is the largest and longest-established company devoted to issuing in-depth reports about insurance organizations. A.M. Best has offices in the United States, United Kingdom, and Hong Kong. Find them online at http://www.ambest.com/