Texas Children’s Health Plan earns 2021 NCQA Accreditation

HOUSTON – (September 16, 2021) – Today, Texas Children’s Health Plan, the nation's first health maintenance organization (HMO) created just for children, announced it has been awarded status of Accredited by the National Committee for Quality Assurance (NCQA), becoming one of only 12 Medicaid plans to earn the NCQA accreditation in Texas. Texas Children’s Health Plan is the top-rated HMO in Patient Experience in the state of Texas, with a rating of 4.5 out of 5 and an overall rating of 3.5 out of 5 in NCQA’s Medicaid Health Plan Ratings 2021.

 

“Earning the NCQA accreditation status and being the top-rated HMO in patient experience in the state is a true testament to our commitment to providing exceptional care to our members,” said Richelle Fleischer, president of Texas Children's Health Plan. “We are honored that our team is recognized for continuously striving to improve our quality and keep our members healthy.”

 

Patient Experience ratings are based on members’ opinions of Texas Children’s Health Plan, its services and providers, underscoring the health plan’s commitment to providing its members with dependable health coverage and delivering top-quality patient care. Notably, Texas Children's Health Plan is also rated among the top plans in the state in prevention, including how well it provides screenings, immunizations and other preventative services.

 

The NCQA’s Health Plan Accreditation is a rigorous assessment of health plans’ structure and process, clinical quality and patient satisfaction in order to continuously improve the quality of care and services provided to health plan members. It is the only program in the industry that bases results on clinical performance and consumer experience (HEDIS ® and CAHPS ®).

 

Health Plan Accreditation performance results are publicly reported in three aggregate areas: patient experience, prevention, and treatment. Within these areas, NCQA evaluates health plans on quality management and improvement, population health management, network management, utilization management, credentialing and recredentialing, members’ rights and responsibilities, member connections, and Medicaid Benefits and services.

 

The NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (www.ncqa.org) contains information to help consumers, employers and others make informed health care choices.

 

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Texas Children’s Health Plan was founded in 1996 by Texas Children’s Hospital. It is the nation's first health maintenance organization (HMO) created just for children. Texas Children’s Health Plan provides STAR/Medicaid and Children’s Health Insurance Program (CHIP) to pregnant women, teens, children, and adults in Houston and more than 50 surrounding East Texas counties. Currently, the Health Plan has more than 540,000 members. Our network of more than 4,300 primary care physicians, 6,800 specialists, and 118 hospitals, includes our two Texas Children’s Hospital Centers for Women and Children, which provide a comprehensive and unique care experience only available to our members. Texas Children’s Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris and Jefferson service areas. For more information on Texas Children’s Health Plan, go to www.TexasChildrensHealthPlan.org or call 1-800-990-8247.