Inside Network Accreditation

UnitedHealthcare Community Plan of Tennessee (TN UHC), is taking steps to become the first managed care organization to achieve CQL Network Accreditation. The pursuit of this prestigious designation demonstrates a strong commitment to improving the quality of services and the quality of people’s lives across the State.

UnitedHealthcare Community Plan of Tennessee

UnitedHealthcare is dedicated to helping people live healthier lives and making the health system work better for everyone by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.3 million physicians and care professionals, and 6,500 hospitals and other care facilities nationwide. The company also provides health benefits and delivers care to people through owned and operated health care facilities in South America. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified health care company. For more information, visit UnitedHealthcare at www.uhc.com or follow @UHC on Twitter.

About Accreditation

CQL Network Accreditation offers states, provider organizations, people receiving services, and other stakeholders guidance, support, and partnership in improving quality through proprietary tools and internationally-recognized person-centered approaches. It encompasses training, workshops, planning meetings, agency assessments, on-site visits, individual interviews, policy reviews, focus groups, and more. Network Accreditation provides TN UHC with a consistent framework for defining, measuring, and evaluating quality from the perspective of the person receiving services. TN UHC can then better assist its members in designing and implementing responsive, person-centered supports so that people can achieve their personally-defined outcomes. The components, tools, and approaches of accreditation expand beyond policies and procedures to exploring how they are actually put into practice and impact lives.

Accreditation Components

Network Accreditation is different from traditional CQL Accreditation, as TN UHC carries out the processes. While the application will differ, the components will remain similar.

  • Pre-Accreditation Planning Meetings
    Conference calls covering the accreditation process
  • Organizational Self-Assessments
    Organization evaluates its operations, validated by CQL (TN UHC)
  • On-Site Visits
    CQL (TN UCH) visits and reviews sites where you provide supports
  • Personal Outcome Measures® Interviews
    Conversations with people supported and staff
  • Basic Assurances® Reviews
    Evaluation of fundamental requirements for agencies
  • Focus Groups
    Separate discussions with staff and people supported
  • Data Collection & Analysis
    Collection and analysis of outcomes and supports data
  • Ongoing Support
    Continual collaboration between CQL and organization

Accreditation Tools

Basic Assurances®

Basic Assurances® evaluate the essential, fundamental, and non-negotiable requirements involving issues of health, safety, and human security, looking at the provision of safeguards from the person’s perspective. These are not statements of intent but demonstrations of successful operations, where the effectiveness of systems or policies are determined in practice, person by person.

Personal Outcome Measures®

Personal Outcome Measures® (POM) are a powerful tool to explore quality of life areas involving choices, relationships, rights, goals, dreams, employment, and more. In a Personal Outcome Measures® interview, people receiving services share information about the presence, importance, and achievement of outcomes. Their support providers then discuss the services that the organization has in place for those outcomes.

Shared Values

Shared Values represent an alignment in culture and philosophies between CQL’s and the organization’s values. These values influence management decisions, organizational priorities, and the character of the workforce. Most organizational decisions related to budget, human resources, or regulatory matters are ultimately decisions about values – what people and organizations believe are important.

Person-Centered Excellence®

Person-Centered Excellence® assesses quality improvement initiatives, including how the managed care organization can implement or enhance those associated practices. The findings from this process can then facilitate strategic discussions about aligning the organization’s mission to make an organizational transformation.