Cigna HealthcareSM and Evernorth® have earned accreditation and certification from The National Committee for Quality Assurance (NCQA) and URAC in acknowledgement of our longstanding history and strong commitment to quality in health care services. The nationally-recognized accreditations by NCQA and URAC affirms the mission statement of Cigna Healthcare and Evernorth to improve the health and well-being of the individuals we serve through an integrated approach to quality and affordability in health care. This mission and approach is a common value shared across several organizations and programs within Cigna Healthcare and Evernorth.
The dedication of Cigna Healthcare and Evernorth to the delivery of quality services is demonstrated by the continuous improvement of business processes through benchmarking against nationally recognized standards. Cigna Healthcare and Evernorth have received several URAC accreditations:
By achieving URAC Accreditation, the case management program displays leadership through a commitment to quality and accountability. People coping with a wide range of health challenges, such as cancer, a transplant or a complicated pregnancy, benefit from the caring support provided to them by case managers. URAC accreditation ensures the delivery of quality services to our customers in managing transitions of care to reduce readmissions, improve and maintain their health. To verify the Case Management accreditation, please visit URAC.org
URAC accreditation provides a mark of distinction for organizations demonstrating their commitment to quality health care. Through the Health Utilization Management Accreditation, URAC affirms the use of evidence-based guidelines and specific review requirements that meet the demands of a changing health care system. The utilization management program is supported by reliable policies and procedures used during the review of health care services for medical necessity and appropriateness of care to help ensure easy access to care and correct administration of our customer’s benefits. To verify the Utilization Management accreditation, please visit URAC.org
Quality health care is crucial to our customers and it is important to be measured against national standards and undergo rigorous evaluation by an independent accrediting body, which validate our commitment to quality. Pharmacy benefit management ensures that contract terms and pricing are clear, so that individuals have access to the drugs and pharmacies they need to be healthy. To verify the Pharmacy Benefit Management accreditation, please visit URAC.org
URAC accreditation provides a mark of distinction for organizations demonstrating their commitment to quality health care. Through the Health Utilization Management Accreditation of Evernorth, URAC affirms the use of evidence-based guidelines and specific review requirements that meet the demands of a changing health care system. The utilization management programs are supported by reliable policies and procedures used during the review of health care services for medical necessity and appropriateness of care to help ensure easy access to care and correct administration of our customer’s benefits. To verify the Utilization Management - behavioral accreditation of Evernorth, please visit URAC.org.
NCQA is a private, non-profit 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®2) is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information for consumers, purchasers, health care professionals and researchers. For more information, please visit NCQA.org.
The following NCQA Accreditations and Certification underscores the commitment of Cigna Healthcare and Evernorth to excellence, quality, and affordable health care to the individuals we serve.
NCQA Health Plan Accreditation evaluates how well a health plan manages its entire delivery system, including physicians, hospitals and other facilities, as well as administrative services. Cigna Healthcare implements and manages numerous activities throughout the organization to ensure processes and opportunities are objectively and systematically monitored, and evaluated, to improve the quality and appropriateness of care and services. This ongoing quality oversight support the success of Cigna Healthcare in earning NCQA Health Plan Accreditation. To view the Health Plan Accreditation Report Card of Cigna Healthcare, please visit www.ncqa.org and select “Report Cards".
The accredited Chronic Condition Management programs of Cigna Healthcare include asthma, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease, depression and diabetes. Earning NCQA Population Health Program Accreditation is an indication that the chronic condition program of Cigna Healthcare is dedicated to giving patients and health care professionals the support, education and other help necessary to facilitate good outcomes and care. NCQA’s Population Health Program Accreditation is designed to help individuals evaluate the chronic condition management programs and to improve patient care and service. To view the Population Health Management Accreditation of Cigna Healthcare, please visit www.ncqa.org and select “Report Cards”.
The NCQA Physician Quality (PQ) Certification program evaluates how well health plans measure, and report the quality and cost of physicians and hospitals. Cigna Healthcare earned PQ certification for two physician quality measurement programs: Physician Quality and Cost Efficiency Displays and Cigna Healthcare Care Designation. This Cigna Healthcare program provides our customers with information about quality and cost, which may help them make better, more informed decisions when choosing physicians. To view the Physician Quality Certification Report Card of Cigna Healthcare, please visit www.ncqa.org and select “Report Cards”.
Evernorth has earned full NCQA Managed Behavioral Healthcare Organization (MBHO) Accreditation for how well it manages its entire delivery system, including physicians, hospitals and other facilities, as well as administrative services. NCQA reviews include rigorous on-site and off-site evaluations conducted by a team of physicians and managed care experts. Earning Full Managed Behavioral Health Organization Accreditation from NCQA is a powerful validation of the ongoing commitment of Evernorth to quality and demonstrates dedication to helping our customers. To view the Management Behavioral Health Organization Accreditation Report Card of Evernorth, please visit www.ncqa.org and select “Report Cards”.
1“Cigna Healthcare” refers to certain health care related operating subsidiaries of The Cigna GroupSM and Evernorth Health, Inc. Such operating subsidiaries include Cigna Health and Life Insurance Company, Cigna Health Management, Inc., Evernorth Behavioral Health, Inc., Evernorth Care Solutions, Inc., Evernorth Direct Health, LLC and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc.
2HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).