CQL | The Council on Quality and Leadership is pleased to announce that UnitedHealthcare Community Plan of Tennessee (TN UHC), is taking steps to become the first managed care organization to achieve CQL Network Accreditation. The path to achieving Network Accreditation is a multi-year process, which will officially begin on 6/1/21. 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.
“Prioritizing CQL accreditation signals our deep commitment to serving people with intellectual and developmental disabilities in Tennessee,” said Keith Payet, CEO, UnitedHealthcare Community Plan of Tennessee. “The process of accreditation will ensure high quality services and enhanced quality of life for our members and we are honored to be the first health plan committed to the process in Tennessee and nationally.”
The Impact of Network Accreditation on TN UHC
CQL Network Accreditation will help build TN UHC’s capacity for quality monitoring and enhancement. The components of Network Accreditation broadly include an alignment with the highest standards in human services, implementation of best practices, integration of CQL’s internationally-recognized tools, utilization of data to assess organizational initiatives, and continuing partnership and collaboration to embrace ongoing transformation throughout the network.
“The pursuit of Network Accreditation shows how dedicated TN UHC is to strengthening the services of its members, and most importantly, enhancing the lives of people with disabilities,” says Mary Kay Rizzolo, president and chief executive officer, CQL | The Council on Quality and Leadership. “We are just starting out on this journey with TN UHC and we’re already inspired by their level of excitement involving Network Accreditation.”
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 with disabilities can achieve their personally-defined outcomes. The components, tools, and approaches of Network Accreditation expand beyond reviewing policies and procedures to exploring how they are actually put into practice and impact people’s lives.
“This process is all about improving services so that people can make their dreams a reality,” adds Katherine Dunbar, vice president of services and systems excellence, CQL | The Council on Quality and Leadership. “Whether it’s getting a job, living independently, or building relationships, Network Accreditation provides TN UHC with clear guidance to ensure its members’ services are supporting people to live the lives they want.”
TN UHC – with support from CQL – will also be launching an informational campaign to educate relevant stakeholders about Network Accreditation, communicate the critical role that each stakeholder plays in the process, and share timely updates about the latest developments. This campaign will be carried out through virtual and in-person meetings, town hall events, webinars, and trainings, along with engagement through print, email, and social media channels.
“Person-centered excellence is the foundation of high quality, cost-effective care that empowers people to live their best lives in community. This is especially true for people who receive long-term services and supports,” said Patti Killingsworth, chief of long-term services and supports, TennCare. “Tennessee was the first state in the country to attain CQL Accreditation of its I/DD delivery system under the Department of Intellectual and Developmental Disabilities. UHC will become the first MCO in the country to earn this distinction. We are so pleased that UHC is making this commitment to serving all of its members, including people with intellectual and developmental disabilities.”
3 Phases of Network Accreditation
Over the course of the next four years, TN UHC will engage in a comprehensive and holistic process to ultimately achieve CQL Network Accreditation. This process is coordinated through three phases that will gradually guide TN UHC during this rigorous, yet rewarding, undertaking. The following descriptions provide a very broad overview of each phase and are not intended to encompass all aspects of the Network Accreditation process.
Phase 1: Network Foundation
The first phase of the process will involve a series of activities to build capacity across Tennessee to learn about and begin utilizing CQL quality improvement tools, including the Personal Outcome Measures® and Basic Assurances®. TN UHC will also begin the process of enacting cultural change across all of its staff and partners. This process is not only essential to achieve buy in from all key stakeholders, but to promote sustainability and ensure effective and lasting impact.
Phase 2: Network Transformation
The second phase involves evaluation of the current state of quality across the UHC network. TN UHC staff will collect data, through the PORTAL Data System, using the Basic Assurances® and Personal Outcome Measures® tools. Taken together, these tools help to determine the overall effectiveness of supports provided by organizations contracted through TN UHC, resulting in meaningful outcomes for people receiving support through the network.
Phase 3: Network Accreditation
The third phase will involve CQL facilitating TN UHC’s What Really Matters plan development. The What Really Matters model is characterized by excellence in person-centered supports which ultimately promote personal quality of life outcomes. This tool is utilized in Network Accreditation models to help facilitate person-centered supports throughout the network. After thoughtful analysis of data obtained in Phases 1 and 2 – and with input obtained through individual focus groups and combined stakeholder groups – TN UHC and stakeholders will select a few factors to target in their journey toward person- centered excellence.
# # #
About CQL | The Council on Quality and Leadership
Since 1969, CQL | The Council on Quality and Leadership has been a leader in working with human service organizations and systems to continuously define, measure, and improve quality of life and quality of services for youth, adults, and older adults with intellectual and developmental disabilities, and psychiatric disabilities. CQL offers accreditation, training, certification, research, and consultation services to agencies that share our vision of dignity, opportunity, and community for all people.
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.
Medicaid Managed Care: The Provider Impact
This webinar will provide an overview of Medicaid managed care, including different service delivery models and the impact on people with IDD. The webinar also highlights the perspective of human service providers and features one large agency’s experience with managed care.View The Webinar