MHR Newsletter
2024 #3
March 14, 2024
By: Nancy Ross Bell
From Susan
It all began years ago when we saw organizations struggling to prepare for their NCQA survey. Starting with just one spreadsheet, MHR has evolved over the past 33 years by building a library of over 100 items that we use in conjunction with our expert consultation on NCQA survey preparation.
Take, for example, an organization that fell behind on delegation oversight and, along with our guidance, used our new Delegation Suite of templates, tools, guides, and training to help close some gaps and provide a foundation to develop, sustain the program, and add new delegates with confidence.
Another organization lacked the staffing needed to maintain their NCQA accreditation and worked with MHR using our new Staffing Assessment to help budget their staffing for the following year.
Numerous organizations have benefited from our training and templates for Quantitative & Qualitative Analysis, helping build consistency across their quality teams.
All organizations want to save resources when complying with NCQA requirements, and we know how. Using our library of resources avoids the time and effort of creating your own tools or developing your own training while ensuring you are working with the most up-to-date standards using the expertise of very experienced accreditation consultants and surveyors.
Now, MHR is preparing to bring you, our valuable clients, a unique opportunity that no other firm that consults on NCQA Accreditation has: the ability for you to view online our over 100 items to purchase and use them as you see fit at a budget that’s right for you. Look for more details by email as we roll out this offering, targeted for the second quarter of 2024.
April 12, 2024 (noon EST), is soon upon us as we have our first client-only training for 2024.
We will bring you the latest updates we heard from our recent NCQA Surveyor training, along with the most impactful of the Policy Clarifications and Changes published at the end of March every year.
It’s not too early to plan to attend the NCQA Innovation Summit Oct 31-Nov 2, 2024, at the Gaylord Opryland Resort in Nashville, TN. Once again, I will be hosting a client-only dinner after the sessions on Nov. 1. Stay tuned for a future email on how to sign up. https://www.ncqasummit.com.
Be sure to read more about MHR’s CONSULTANT, Tina Morton, and her active life outside NCQA consulting!
Are you a sister company of a larger parent organization? Read our latest update on a question we asked NCQA under Quality Insights.
As always, let me or your MHR Consultant know how we can guide you along your NCQA journey.
Susan K. Moore, President & CEO
Is there a topic you want to read more about in our blogs or newsletter? We welcome your input! Send your thoughts to Nancy Rossbell
GET TO KNOW MORE ABOUT
Tina Morton, BSN, RN, CCM, CPHQ
MHR Consultant
When you get to know Tina Morton, you will find she is highly committed to her client’s success, is an endearing grandmother of three, and loves animals!
Moving from a corporate work environment to an independent consultant with MHR in 2018 was new and challenging for Tina, yet very familiar. Before joining MHR, she had six years of NCQA Surveyor experience, which she continues today with at least four NCQA surveys a year plus Surveyor training three times a year. Tina specializes in NCQA Accreditation for Health Plans, Health Equity, Credentialing Verification Organizations, Credentialing, Case Management, and Long-term Services and Supports.
When working with Tina, you can be assured that she understands what organizations experience during their survey preparation. Her work experience leading Accreditation teams for national and local health plans and specializing in behavioral health, quality, case management, and utilization management brought valuable insight that she carries over to MHR’s clients today.
Tina finds great satisfaction in building relationships, guiding teams in problem-solving their unique challenges, and sharing her technical accreditation skill set. Like all of MHR’s Consultants, Tina taps into her colleagues and MHR resources as situations arise. That ultimate fulfillment comes when her influence as a consultant leads to a successful accreditation!
Tina values Susan Moore’s business concept, her longstanding rapport with NCQA, and the resources she makes available to her consultants. Susan employs an environment of continuous quality improvement among her teams, providing regular training and team meetings, a library of resources, and individual consultative support and feedback. As an MHR Consultant, you always have other team members to call upon when clients need urgent support or perhaps experience in an area where other insight is valuable.
As committed as Tina is to her NCQA consulting, that is not all she does! Tina is a proud mother of a daughter and devoted grandmother of three, ages 6, 4, and 8 months, which sometimes entails out-of-state travel.
Being a lover of animals, Tina was a volunteer for Collie rescue, previously owned four horses, of which one lived to age 34, had a three-pawed dog to which Tina applied her nursing skills and purchased a prosthesis to help him ambulate, and currently rescues cats. Her love of animals doesn’t stop there! She rode an elephant at a local circus, a camel in Morocco, and fed a giraffe at a local New Jersey zoo!
When NCQA, grandkids, and pets are not keeping her occupied, she enjoys growing orchids, attending yoga, exercising at the gym, and having lunch with friends near her home in New Jersey. What’s next for Tina? Her goals in 2024 are learning to juggle, which we’ll want to see, and play chess!
Learn more about Tina at our other consultants at About Our Consultants.
NEWS
Access in Brief: Adults with Intellectual Disabilities and Developmental Disabilities
Can Artificial Intelligence Improve Prior Authorization?
Change Healthcare Cyberattack Having ‘Far-Reaching’ Effects on Providers
7 Healthcare Trends We're Watching Now
2024 Telehealth Reimbursement Updates: Expanding Access and Optimizing Care
Rise in Healthcare Data Breaches & the Impact for Healthcare Providers in 2024
Medicaid Enrollment and Unwinding Tracker
Operational Framework for Monitoring Social Determinants of Health Equity
The Data Behind the Provider Directory: Why Provider Data is Key
QUALITY INSIGHTS
We asked NCQA for you!
When you have a question specific to your organization and can’t find the answer in the standards, be sure to ask your MHR Consultant so we may get clarification from NCQA. Here is one we asked about what documentation is needed when a sister organization adopts policies and procedures from its corporate parent.
Corporate Families Must Show Evidence and Documents
As explained in NCQA’s Appendix 2, if a wholly owned corporate family member performs all functions associated with a structural requirement for the organization, the organization may provide the documentation of its corporate family member in lieu of providing its own documentation or formally adopting the documentation of the corporate family member.
MHR confirmed with NCQA the following:
- The organization pursuing accreditation must provide an inter-company agreement between the entities explaining that the organization is adopting the policies and procedures associated with the structural requirement functions being performed by the sister company (organization).
- NCQA looks for evidence from the organization’s formal approving body that it approved of or adopted specific data sources and policies and procedures as applicable. Evidence includes committee minutes or leadership team member approver’s signature (as applicable), an approval date, and an effective date.
- If the organization decides to adopt documentation, it must present an inter-company agreement, evidence of adoption as demonstrated through formal minutes or leadership team member signature with approval and effective dates, and the adopted document for review. See NCQA’s Appendix 2 of your standards.
Have a questions for NCQA? Ask us, and we’ll be sure to frame it to ensure it is clear and specific to your situation.
News from NCQA:
Behavioral Health Networks: What We Know Now
NCQA’s Health Plan Ratings 2024
Health Equity Accreditation FAQs
Keep updated with MHR’s Blogs!
One of our latest blogs is on Qualitative Analysis, where we give you an example using the 5 Whys Method of root cause analysis for a problem with network availability.
Tech Tip
Have you ever been in the middle of writing a report in Microsoft Word and decided it would be better presented in a table format? Don’t rewrite it. Follow these steps:
- Highlight the text
- Click on Insert
- Click on Table, then Convert Text to Table
- Decide the number of columns needed
- Allow auto fit of content (You can change it later if desired)
- Click on OK
To make changes to the table, highlight the content and select Table Design or Layout at the top.
UPCOMING INDUSTRY EVENTS
April 2-3, 2024
RISE The Medicaid Managed Care Leadership Summit
- Virtual
April 11, 2024
AHIP Increasing Access to Care Through Care Team Evolution
- Webinar
April 12, 2024
MHR’s Client-Only Training – Save the Date
- Live Webinar
April 19-22, 2024
2024 National Conference American Case Management Association
- Nashville, TN
May 1-3, 2024
RISE The Special Needs Plan Leadership Summit
- New York
May 29-30, 2024
CMS Health Equity Conference
- Bethesda, MD/Virtual
June 2-4, 2024
RISE Qualipalooza 2024
- Atlanta
- Las Vegas, NV
August 9, 2024
MHR’s Client-Only Training – Save the Date
- Live Webinar
September 9-11, 2024 – Save the Date
NAHQ Next 2024
- Virtual
October 31-November 2, 2024 - Save the Date
NCQA Health Innovation Summit
- Nashville, TN
December 13, 2024
MHR’s Client-Only Training – Save the Date
- Live Webinar
CALENDAR OF OBSERVANCES
Have you made plans to increase awareness of these observances?
March
American Diabetes Alert Day – March 26, 2024
April
National Infant Immunization Week (April 21-27)
Administrative Professionals Day (April 24, 2024)
May
National Nurses Week (May 6-12, 2024)
Melanoma/Skin Cancer Detection Month
Osteoporosis Prevention and Detection Month
June
MHR was incorporated in 1991 and specializes in preparing organizations for all NCQA accreditation and certification products.
All MHR consultants were responsible for NCQA accreditation in their previous roles before joining MHR as an independent consultant. Most consultants are also NCQA surveyors and the majority are clinicians.
We welcome hearing from you!
Contact Us