Скачать или смотреть Behavioral Health & Case Management: Comparing NCQA and URAC Accreditation Models

In this episode, Susan Moore, Founder and CEO of Managed Healthcare Resources, and Leslie Brown Shuler, former URAC Clinical Accreditation Reviewer, unpack the critical differences in how NCQA and URAC handle behavioral health and case management accreditation.

They explore what’s included in each accreditor’s framework — from program scope and structure to how organizations can tailor accreditations to meet their populations’ needs.

In This Episode:
✔️ Behavioral Health Accreditation: Standalone vs. Integrated

✔️ Why NCQA’s Behavioral Health Accreditation stands alone and includes both Utilization Management (UM) and Case Management (CM) components

✔️ How URAC’s behavioral health programs are segmented into Behavioral Health, Mental Health Parity, and SUD (Substance Use Disorder) Parity

✔️ The integration of behavioral health within URAC’s Community Health Worker program, expanding the continuum of care

Case Management: Depth, Flexibility, and Accreditation Options

✔️ NCQA’s approach: a limited case management standard inside Health Plan Accreditation, with a comprehensive standalone option for organizations seeking deeper recognition

✔️ URAC’s model: 100% standalone Case Management Accreditation, allowing organizations to choose between complex, transitional, or disease-specific programs

✔️ How each accreditor’s design affects operational workload and alignment with care delivery models

Strategic Takeaways for Healthcare Organizations

✔️ How to decide whether a standalone or integrated accreditation is right for your organization

✔️ The benefits of flexibility in URAC’s structure vs. NCQA’s more comprehensive, all-in-one model

✔️ Why understanding these nuances can prevent duplicate work and ensure better compliance outcomes

“With NCQA, behavioral health accreditation is robust and comprehensive; URAC offers flexibility through multiple, more focused programs. The right fit depends on your organization’s scope and structure.” — Susan Moore

Timestamps

00:00 — Behavioral Health Accreditation: NCQA vs. URAC
00:05 — How Behavioral Health Is Integrated into URAC’s Programs
00:10 — Case Management Standards: NCQA’s Limited vs. URAC’s Standalone Approach
00:15 — Choosing the Right Accreditation Model for Your Organization

Contact MHR:
LinkedIn:   / managed-healthcare-resources-inc  
Website: Managedhealthcareresources.com
Contact us: https://www.managedhealthcareresource... or [email protected]


Get our free resources to assist you with your NCQA or URAC Accreditation Journey:

📌 NCQA v. URAC Get Our Program Comparison Checklist: https://www.managedhealthcareresource...

📌 Understanding URAC Accreditation Programs Guide: https://www.managedhealthcareresource...

📌 How to Hire for Accreditation: Get the DISC Assessment checklist: https://www.managedhealthcareresource...

📌 NCQA Accreditation Publishing/Mailing Case Example Requirements Tool: https://www.managedhealthcareresource...

📌 URAC Pre-application Checklist https://www.managedhealthcareresource...

📌 Choosing an NCQA Consultant Guide: https://www.managedhealthcareresource...