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16 Jul 2018

ProgenyHealth Awarded Full NCQA Accreditation for Utilization Management and Case Management

posted under Press Releases

NCQA Recognizes ProgenyHealth’s Commitment to Delivering Highest Standards of Clinical Quality in Neonatal Care Management

Plymouth Meeting, PA, July 16, 2018 – ProgenyHealth, LLC, a leading neonatal care management company, announced today that it was awarded full accreditation by the National Committee for Quality Assurance (NCQA) for their Utilization Management and Case Management programs.

The NCQA Utilization Management and Case Management Accreditation surveys include rigorous off-site and on-site evaluations of twenty-five standards. Health care entities are measured on standards such as: Internal Quality Improvement Process, Clinical Criteria for UM Decisions, Timeliness of UM Decisions, Care Transitions, and Measurement and Quality Improvement.

“Achieving Utilization Management accreditation from NCQA demonstrates that ProgenyHealth has the systems, process and personnel in place to conduct utilization management in accordance with the strictest quality standards,” said Margaret E. O’Kane, President of NCQA.  “Case Management Accreditation moves us closer to measuring quality across population health management initiatives. Not only does it add value to existing quality improvement efforts, it also demonstrates an organization’s commitment to the highest degree of improving the quality of their patients’ care.”

“We are extremely proud of this achievement, knowing that our focused programs of utilization management and complex case management for high-risk neonates have been externally validated by one of the nation’s most prestigious accrediting bodies,” said Dr. Steven Richardson, Chief Medical Officer of ProgenyHealth. “This recognition illustrates ProgenyHealth’s steadfast commitment to clinical excellence and to providing quality care to our client’s members.”

ProgenyHealth’s recent NCQA accreditation, together with their URAC accreditations, confirms their commitment to delivering quality-based solutions to their clients and their clients’ NICU population.

About ProgenyHealth

ProgenyHealth is the only national company focused exclusively on NICU Care Management. Our team takes a holistic approach to working with health plans, providers and families throughout the first year of life.  ProgenyHealth neonatologists, nurses and social workers work collaboratively with providers to ensure health care services follow evidence-based best practices and are medically necessary. Our proactive conversations with providers and families naturally drive down costs and improve health outcomes.

Over the past fifteen years, ProgenyHealth has successfully managed thousands of NICU infants and delivered positive results to all our health plan partners.  Working with over 1000 hospitals and 6000 providers nationwide, we are measurably improving health outcomes for premature and medically complex newborns. For more information on our programs and services, please visit www.progenyhealth.com.

About NCQA

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 Web site (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.


Contact: Lisa Lawrence

Telephone: 484-362-6584

Email: llawrence@progenyhealth.com