PerformCare® Awarded Full Managed Behavioral Health Organization Accreditation by NCQA

PerformCare Achieves an NCQA Rating of 99.8 out of 100

November 18, 2021 - Harrisburg, Pa.

Harrisburg, Pa. — PerformCare, a full-service managed behavioral health care organization and member of the AmeriHealth Caritas Family of Companies, announced today that it has earned full Managed Behavioral Health Organization (MBHO) Accreditation for its Pennsylvania business from the National Committee for Quality Assurance (NCQA) for the sixth consecutive time. It achieved a score of 99.8 out of 100.

The accreditation covers PerformCare’s programs for HealthChoices, Pennsylvania’s Medicaid managed care program, and is a designation it also received in 2006, 2009, 2012, 2015 and 2018. This year’s accreditation can be attributed to PerformCare’s high quality behavioral health care and service for its members.

“Providing excellent service is a constant mindset at PerformCare,” said Jim Laughman, M.S.W, L.S.W., president of PerformCare. “Receiving another full accreditation reflects success in achieving our goal of providing best-in-class behavioral health care management services to adults, children and families throughout the Commonwealth of Pennsylvania. By providing these services to HealthChoices members we are helping Pennsylvanians get care, stay well and build healthy communities.”

NCQA Accreditation for MBHOs evaluates how well a health plan manages all parts of its delivery system — physicians, hospitals, other providers and administrative services —  to continuously improve health care for its members. NCQA reviews include rigorous on-site and desktop evaluations conducted by a team of physicians and managed care experts. A national oversight committee of physicians and behavioral health providers analyzes the team's findings and assigns an accreditation level based on the MBHO's performance compared to NCQA standards.

PerformCare’s focus on quality contributed to its high rating, as did these strategies:

  • Member access to treatment is a top priority for PerformCare. Two quality improvement projects were initiated which increased access to targeted case management and family-based mental health services.
  • PerformCare developed a survey to measure the exchange of information between behavioral health providers with a focus on member transition of care. Based on the survey results, action steps were taken annually to improve continuity of care.
  • Complex case management utilized an adult needs and strengths assessment, which led to a specific needs focus in treatment plans. Social determinants of health needs were then addressed prior to discharge, helping members achieve positive behavioral health outcomes.
  • The credentialing process scored 100%, due to an active credentialing committee and well-defined policies and procedures.

“PerformCare’s MBHO Accreditation is proof that it’s an organization that works hard to coordinate care, provide access and good customer support for members,” said Margaret E. O’Kane, NCQA president. “It’s a sign PerformCare is focused on improving the behavioral health of its members.”