Priority Health Earns NCQA “Excellent” Accreditation

Health plan awarded highest level of accreditation, proving commitment to quality health care

GRAND RAPIDS — Priority Health Monday announced it has earned an “Excellent” accreditation by the National Committee for Quality Assurance, the highest level a health plan can earn, for its Commercial HMO/POS, Medicaid, Medicare PPO, and Medicare HMO/POS plans. Priority Health is an award-winning health plan nationally recognized for creating innovative solutions that impact health care costs while maximizing customer experience.

The plan continues to be the first and only Michigan-based organization with Wellness & Health Promotion Accreditation from the NCQA.

The NCQA accreditation process is the industry’s most rigorous, comprehensive, and transparent accreditation program. It provides consumers and businesses with an unbiased third-party review to verify, score, and publicly report health plan performance across the nation.

All plans with NCQA accreditation are evaluated in five categories: quality management and improvement, utilization management, credentialing, members’ rights and responsibilities, and member connections. In addition, plans are rated on their performance on process and outcomes in clinical care and member experience of care based on the Healthcare Effectiveness Data and Information Set.

To receive the score of “Excellent,” a plan must exceed requirements for consumer protection and quality improvement, and HEDIS results must be in the highest range of national performance. Priority Health has achieved “Excellent” accreditation from the NCQA since the rating was established in 1999.

This accreditation proves to current and potential clients that services are exceptionally valuable, according to Jim Byrne, MD, chief medical officer for Priority Health. “It is only through our longstanding working relationships with physicians … that we continue to earn this high level of distinction.”

Priority Health has made significant investment in supporting physicians in their work. It is why the company created its physician incentive program, Partners in Performance, more than 15 years ago. As part of the Partners in Performance, Priority Health recognizes the top performing primary care physicians and physician groups for ensuring patients receive preventive care, control their chronic conditions, and have an exceptional experience. An overview of the program and its results is available on or through the Priority Health Find a Doctor tool.