NCQA Awards BlueCross MCO Accreditation Status of Excellent

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Accreditation Fulfills TennCare Bureau Mandate for all MCOs

Achieving an accreditation status of Excellent is a significant achievement for a health plan

Volunteer State Health Plan (VSHP), a licensed HMO affiliate of BlueCross BlueShield of Tennessee, Inc. (, announced today it has been awarded an accreditation status of 'Excellent' from the National Committee for Quality Assurance (NCQA), an independent, non-profit organization that assesses and reports on the quality of the nation's managed care plans.

VSHP's accreditation status of Excellent -the highest possible level- is based on a voluntary review of how a health plan ensures that its members are receiving high quality care. VSHP scored 93.20 out of a possible 100.00 points. The accreditation is valid through Feb. 11, 2009.

"Our MCO has always strived to provide the highest-quality clinical care and member satisfaction to those Tennesseans relying on us for Medicaid services, and this NCQA accreditation validates those efforts," said VSHP Vice President Sonya Nelson. "The confirmation of our excellence is good news for not only us, but also our members."

The achievement meets the TennCare Bureau's NCQA accreditation requirement for any managed care organization participating in the TennCare program. TennCare is the first Medicaid program in the nation to adopt such a mandate.

"Achieving an accreditation status of Excellent is a significant achievement for a health plan," said Margaret E. O'Kane, president of NCQA. "It is only awarded to those plans that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement and have HEDIS results in the highest range of national performance."

The NCQA accreditation survey process includes on and off-site evaluations of over 60 standards and selected HEDIS performance measures conducted by a team of physicians and managed care experts. A committee of physicians analyzes the team's finding and assigns an accreditation level based on the performance level of the plan being evaluated to NCQA's standards.

The NCQA accreditation process evaluates how well a health plan manages quality throughout every part of its delivery system -physicians, hospitals, affiliated providers, and administrative services- to continuously improve health care for its members.

VSHP, a licensed HMO of BlueCross BlueShield of Tennessee, Inc., was the first managed care organization to commit to Tennessee's Medicaid program (TennCare) in 1993. Through its BlueCare and TennCare Select programs, VSHP serves more than 600,000 TennCare beneficiaries. Services provided include claims processing, care coordination, disease management and case management.


Mary Thompson

BlueCross BlueShield of Tennessee, Inc



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