CVS Caremark Earns NCQA Re-Accreditation for Utilization Management

Female mountain biker, rolling down a hill
BRIEFING
March 22, 2018
Executive Vice President and Chief Medical Officer, CVS Health

CVS Health’s pharmacy benefit manager (PBM) CVS Caremark, earned the NCQA — or National Committee for Quality Assurance — Utilization Management Accreditation for another two years. This is the third consecutive accreditation since 2014. The NCQA quality assessment program focuses on consumer protection and customer service improvement. Its standards recognize that accredited organizations have open access networks, and can improve service quality and utilize customized structures to meet purchaser needs.

The Accreditation Survey includes a rigorous evaluation conducted by a team of physicians and managed care experts. An independent review oversight committee of physicians analyzes the team’s findings and assigns an accreditation status based on the organization’s performance against standards.

Achieving independent, third-party accreditations is part of our commitment to meeting the strictest quality standards and ensuring that plan members have access to clinically appropriate, cost-effective therapies that help improve outcomes and lower costs. Maintaining accreditations is a reflection of our overall focus on ongoing improvement and continuous learning, and ensuring that we provide high-quality patient and member care over the long term. It also helps ensure we are helping payors meet their goals of patient safety and improved health outcomes — both of which are key to lowering overall health care costs.

Ongoing Commitment to Quality 

As a company committed to innovation and helping people on their path to better health, we pursue a range of accreditations from independent, highly respected organizations like NCQA, which set stringent standards and require rigorous preparation. 

  • NCQA: Full Patient and Practitioner Oriented Disease Management accreditation for Accordant in 17 disease states, including hemophilia, rheumatoid arthritis, multiple sclerosis, Crohn’s disease and cystic fibrosis. Accordant also holds NCQA accreditation for Case Management. 
  • Advanced Care Scripts, a CVS Health Company, is accredited as a specialty pharmacy by URAC, which requires a comprehensive commitment to meeting quality standards for a range of indicators, including health outcomes, processes, and patient care, education, and satisfaction. 
  • National Association of Boards of Pharmacy: Accredited under the programs Verified Internet Pharmacy Practice Sites and Verified-Accredited Wholesale Distributors. 
  • International Organization for Standardization: Data center certified since 2002, under the ISO 9001:2008 standards.
  • The Joint Commission: Accreditation for CVS Specialty pharmacies, including all locations of Coram CVS Specialty infusion services. Coram also meets and exceeds sterile (safe) quality standards (USP 797), as well as clean room procedures supported through defined standards.

We have long led the industry in seeking independent verification of quality and meeting — or exceeding — such standards. CVS Pharmacy was the first retail pharmacy to receive URAC’s Community Pharmacy accreditation and MinuteClinic was the first retail health care provider to be accredited by The Joint Commission.https://www.jointcommission.org/accreditation/accreditation_main.aspx. March 2018.

Want to learn more about our commitment to quality and patient safety? Ask Us
BRIEFING
March 22, 2018
Executive Vice President and Chief Medical Officer, CVS Health

Explore Programs

Patient Care

Care for specialty patients is complex. A holistic approach helps ensure that patients have proactive clinical support as well as access to medication, helping to improve outcomes and lower costs.

Member Engagement

Our success in helping people on the path to better health depends on how well we engage members and encourage them to take the right steps.

Transform Care

Help to improve health outcomes and reduce overall cost of care with condition-specific management programs.

Image source: Licensed from Getty Images, 2018.

©2018 CVS Health. All rights reserved.