Don’t Gamble with Quality: Schedule an MHR Staffing Assessment To Keep You NCQA Survey-Ready

By Nancy Ross Bell, RN

Estimated time to read: 3 minutes

A new calendar year is right around the corner. For many organizations, it also starts a new fiscal year.  As organizations face budgetary constraints, be sure not to short-cut staffing needed to maintain healthcare quality!

Unless you look at your NCQA survey results, CAHPS scores, or HEDIS measures, quality can sometimes feel invisible in some organizations until it’s time for STARS bonuses or value-based payments to providers where quality hits the bottom line.   

However, quality does not come without the expertise and effort of qualified individuals who are well-trained in NCQA standards.  Before the new calendar year rolls around and you put the final touches on your budget, plan your dollars wisely to ensure you can handle what is needed for your NCQA survey.

Our advice? Schedule an objective Staffing Assessment to reveal your readiness to meet NCQA requirements.

Why Staffing Assessments Matter for NCQA

One unfortunate commonality that MHR sees when consulting is that leaders responsible for NCQA quality accreditation do not have the experience to really know what they need. So what happens? Sometimes, nothing, leading to IT systems not up to par, untrained staff, poor reporting, missed deadlines, mass frustration, corrective action plans, and low survey scores!

Whether you are preparing for your first NCQA accreditation or a renewal survey, your organization’s success hinges on having the following:

• the right number of people
• in the right roles
• who are trained to the NCQA standards
• can apply critical thinking and produce results

Is Your Organization Considering Any of the Following?

• NCQA Accreditation in a new program, such as Health Equity
• New regulatory environment requiring additions, such as LTSS Distinction or meeting additional Medicaid standards
• A merger, acquisition, or consolidation (MAC)
• Expansion into a new market
• New product line

If yes, then chances are, your staffing will be impacted. 

Where Should You Start?

• Determine if leaders in all impacted areas have the requisite knowledge and skills
• Identify subject matter experts (SMEs) for each standard set
• Determine if staff has the bandwidth to manage all NCQA-related tasks
• Assess the NCQA knowledge of new and existing staff
• Audit compliance with requirements

Barriers to Proper Staffing for NCQA

Organizations often face three primary challenges:

• Misunderstanding the Complexity of NCQA Standards: Not all NCQA standards are equally intense. Leaders sometimes underestimate the work required for specific standards, resulting in insufficient staffing.
• Assuming data requirements are “somewhere”: Not having the right data leads to staff inefficiencies in trying to “make up” for what has not been properly collected. Did you know that MHR has templates for formalizing all the data needs for the analysis standards to identify sources and when to access the data? These can be completed by staff only or assisted by the MHR consultant when working on the analytical standards.
• Finding Qualified Staff: Hiring individuals with deep NCQA expertise can be challenging. It can take a year or more to fully onboard and train new staff on NCQA processes. Qualified staff are needed throughout the NCQA survey cycle. MHR have clients where the consultants have more longevity and institutional knowledge than any of the accreditation-related staff!

Let’s Cut to the Chase

As a senior leader, you are responsible for ensuring resources are available to do the job.  Don’t put your SMEs in compromised positions because of the lack of planning on your part!

Put us in touch with your senior leaders who can provide the information; then, we will do the rest.

MHR Consultants have developed a comprehensive Staffing Assessment process that accompanies our consultation, which aligns organization resources with NCQA requirements.

Along with MHR’s Consultation, you receive:

• An Executive Summary outlining the staffing proposal
• An assessment of staffing by NCQA standard
• A detailed list of positions needed to meet requirements, customized by your organization’s job titles, departments, and FTE (full-time equivalent) status
• A customized action plan that includes timelines and key milestones to align with your survey submission

What Are Your Risks of Doing Nothing?

Without proper staffing for your NCQA survey, organizations risk:

• Poor reporting
• Missed deadlines
• Overburdened and stressed-out staff
• Corrective Action Plans
• Loss of accreditation
• Not meeting regulatory requirements

Call to Action:

• Don’t delay. Year-end is quickly approaching. Talk with your MHR Consultant.
• Schedule a Staffing Assessment

MHR follows a quality review process for all blogs. This blog was written with insights from Kim Carpenter Petit. Please read more about Kim and MHR’s other Independent Consultants at ManagedHealthcareResources.com/About Our Consultants.  

MHR: Driving healthcare quality one NCQA accreditation at a time

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