NCQA Updates 2025 Credentialing Product Suite

WASHINGTON, August 7, 2024 (Newswire.com) - The National Committee for Quality Assurance (NCQA) announced updates to its Credentialing Product Suite, which provides a framework for healthcare organizations to implement industry best practices that help them accurately and efficiently credential and recredential licensed health care professionals to ensure an overall safe health care system.

The focus of the 2025 updates to the Credentialing Product Suite ensure that organizations can maintain a high-quality network for members and clients, while providing a framework for adopting industry best practices to promote accurate and efficient verification of practitioner credentials – ensuring that medical organizations employ qualified professional and align with state requirements. 

“The NCQA credentialing standards are a source of best practices for implementing and sustaining high-quality care across the delivery system,” said NCQA President Margaret E. O’Kane. “The 2025 updates to the Credentialing Accreditation product suite align standards with the changing market landscape, stakeholder needs and regulatory requirements, to assist organizations in their pursuit of delivering quality care to all patients.”

Through public comment, interviews with customers, potential customers and industry experts, NCQA set out to learn more about the current state of credentialing and its challenges, barriers and innovations. NCQA also issued a survey, participated in the National Credentialing Forum and attended the National Association Medical Staff Services Education Conference to ensure program evolutions benefit all organizations.

Some key 2025 updates include:

• Single Credentialing Program. NCQA is transforming their Credentialing products into a Single Credentialing program by consolidating the NCQA consolidated Credentialing Accreditation and Credentials Verification Organization (CVO) Certification. There will also be options for individual Certifications (e.g., Credentialing Certification – License to Practice) or an overall Accreditation. NCQA recognizes the opportunity for Certification status to reflect to functions performed. This will also provide the opportunity for additional organizations beyond traditional CVOs to consider Credentialing Certification.
• Shorter Verification Timeframes. The shortened timeframe will enable organizations to access and work with more current data, which is key for risk mitigation, patient protections and allows for accelerated timeframes for assembling credentials, leading to shorter network enrollment periods. 

The original timeframe was set when organizations used manual processes to obtain credentials from primary sources. Technological advancements and approved primary sources that aggregate data from multiple primary sources have helped shorten the time it takes to obtain this information. Credentials are dynamic in nature, and this reduced timeframe will help organizations to work with more recent data.

• Interim Survey. NCQA will introduce a new Interim Survey option, which is a review of an organization’s policies and procedures and provides organizations a glidepath to full Credentialing Accreditation within 18 months. Increasing the number of organizations that align with NCQA standards helps reduce burden across the delivery system and mitigate risk. This is an ideal option for those seeking first time Accreditation.  

For more information about NCQA Credentialing visit Credentialing Accreditation or Credentialing Certification.

About NCQA

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

Source: National Committee for Quality Assurance (NCQA)