What managed care organizations need to know about the renamed, redesigned program replacing Health Equity Accreditation.

If your organization holds NCQA Health Equity Accreditation — or has been considering it — the program you know has been replaced. Starting with surveys on or after July 1, 2026, it is called Health Outcomes Accreditation and Community Focused Care. And while the name change is the easy part to communicate, the substance underneath it is what demands your attention now.

This is the first in a five-part series breaking down everything managed care organizations need to know about NCQA's 2026 restructuring. We start with the structural changes and the single biggest new requirement: a brand-new standard on disability accommodations with no prior equivalent in the Health Equity program.

This is not a rebrand. Health Outcomes Accreditation introduces new standards, retires others, and expands NCQA's expectations well beyond race, ethnicity, and language equity.

Two Programs, Now Independent

NCQA's two health equity programs have new identities for 2026:

• Health Equity Accreditation → Health Outcomes Accreditation (HO)
• Health Equity Plus Accreditation → Community-Focused Care Accreditation (CFC)

More importantly, the two programs are no longer structured as a tiered sequence where you had to either first earn HE accreditation before pursuing HE Plus, or submit them at the same time. Organizations may now pursue Health Outcomes Accreditation or Community-Focused Care Accreditation independently, or pursue both simultaneously. If your organization previously felt it needed to "do Health Equity first" before tackling the Plus program, that constraint no longer exists.

What this means for your organization

Review your accreditation strategy. Organizations that planned a multi-year sequence may be able to accelerate, consolidate, or restructure their timeline now that both programs are independent tracks.

The Headline Change: Disability Is Now a Full Standard

The most significant structural addition in the 2026 Health Outcomes standards is a brand-new Standard — HO 4: Access and Availability of Disability Accommodations. It has four elements. None of them existed in any form under Health Equity Accreditation.

NEW IN 2026

HO 4 is an entirely new standard. Every element requires building processes from scratch. There is no prior Health Equity work to carry forward.

The four elements are:
• HO 4, Element A: Availability of Disability Accommodations — the organization must demonstrate that accommodations are available to members or patients who need them.
• HO 4, Element B: Care Delivery Supports for Disability Accommodations — how the plan supports contracted care delivery sites in providing those accommodations.
• HO 4, Element C: Health Plan Supports for Disability Accommodations — plan-level supports, which are evaluated separately from site-level requirements in Element B.
• HO 4, Element D: Accessible Digital Content — covers accessibility of digital member-facing content, likely aligned with ADA and WCAG web accessibility standards.

This new standard does not exist in isolation. It connects directly to two new data collection elements in HO 2 (covered below) and to new practitioner network elements in HO 5. Disability runs as a thread through multiple standards in the 2026 framework. Organizations that treat it as a single checkbox will miss the full picture.

Gender Identity Data Collection Has Been Retired

RETIRED
Former HE 2, Element D — Collection of Data on Gender Identity — no longer exists in the 2026 Health Outcomes standards.

This is a meaningful rollback from what the Health Equity standards required. The gender identity data collection element has been fully retired. Gender identity has also been removed from the element stems of two other elements: HO 2, Element I (Privacy Protections for Demographic Data) and HO 2, Element J (Notification of Demographic Data Privacy Protections).

Sexual orientation data collection — now HO 2, Element C — is retained but revised. These are two distinct requirements. Organizations should be careful not to conflate them when updating their gap analyses and documentation.

If your organization built gender identity data collection infrastructure specifically to meet Health Equity Accreditation requirements, that work is no longer assessed under Health Outcomes. It may still be valuable practice for your internal goals or projects— but it is no longer a scored requirement.

HO 2: The Data Collection Standard Grew From 7 to 10 Elements

The former HE 2 standard had seven elements. HO 2 now has ten. The additions reflect the program's expanded scope into disability and geographic data:

• HO 2, Element A (Race and Ethnicity) — updated to incorporate the 2024 OMB race/ethnicity categories in factors 1 and 4. Organizations using the older OMB framework must update their data collection tools. The 3.30.26 Policy Changes specified that Materials no longer needed for a data source.
• HO 2, Element B (Language) — factor language, scope of review, and exceptions updated.
• HO 2, Element C (Sexual Orientation) — revised stem, factors, scope of review, and a new element-level exception.
• HO 2, Element D (Disability Status) — NEW. No prior equivalent. Organizations must now collect disability status data from members or patients.
• HO 2, Element E (Disability-Related Accommodations) — NEW. No prior equivalent. Separate from disability status — this element focuses on collecting what accommodations individuals need.
• HO 2, Element F (Classification of Geographic Data) — NEW. Organizations must now classify geographic data, likely to support disparity analysis tied to underserved areas.
• HO 2, Element G (Evidence of Data Collection or Classification) — NEW. Consolidates the evidence requirements across the data collection elements into a single, separately scored element.
• HO 2, Elements H, I, and J — formerly HE 2, Elements A, F, and G respectively. All carry revisions to factors, scoring, scope of review, and exceptions. Gender identity removed from Elements I and J.

ACTION ITEM

Check your race/ethnicity data collection framework against the 2024 OMB categories. The 2024 update reorganized racial and ethnic categories, and organizations that have not updated their collection tools will not meet HO 2, Element A requirements.

NOTE: some Medicaid organizations contend that they only have what the State provides to them for REL data and do not need to fill in gaps that the State does not have. PCS disagrees and states you must have a method (documented process) and reports of doing so.

HO 1: Staff Training Refocused

The former HE 1 had two elements. HO 1 now has one.

• HE 1, Element A (Building a Diverse Staff) — fully retired. No equivalent in HO standards.
• HE 1, Element B (Promoting Diversity, Equity and Inclusion Among Staff) — carried forward as HO 1, Element A, but renamed to Trainings to Improve Care or Service Delivery. The focus shifts from general DEI training to training that directly improves how staff deliver care and services.

The scope of who must be trained and what constitutes qualifying training may differ under the new framing. Review the updated factor language carefully before assuming your existing training program still meets the requirement. This standard requires reports and materials and is a structural requirement. The organization must present its own documentation.

Three new data collection requirements — disability status, disability-related accommodations, and geographic data — mean most organizations have net-new infrastructure work ahead of them, not just documentation updates.

Ready to get started?

Our team has worked with over 10 organizations for Health Equity initial and five renewal surveys, all of which were very successful in their NCQA surveys. We help managed care organizations conduct Health Outcomes readiness assessments, gap analyses, trainings, and survey preparation under the 2026 standards.

Contact us to schedule your review and support [email protected] or Managedhealthcareresoures.com/contact.

Next in this series: Blog 2 covers HO 5 (practitioner and care site network requirements, including a critical NCQA policy clarification for health plans that contract with — but don't own — clinical facilities), HO 6, HO 7, and delegation.

© Managed Healthcare Resources, Inc. 2026