Office Administrative Assistant Practice Exam

Which organization accredits health insurance plans and medical-service businesses through the HEDIS evaluation system?

1. NCQA

2. FDA

3. AMA

4. CMS

The correct answer is: NCQA

The correct answer is the National Committee for Quality Assurance (NCQA). This organization is responsible for accrediting health insurance plans and medical-service businesses based on the Healthcare Effectiveness Data and Information Set (HEDIS) evaluation system. HEDIS is a standardized set of measures used to evaluate the quality of care provided by these organizations. It helps consumers compare healthcare plans and encourages plan providers to improve the quality of their services. The NCQA’s role is critical in ensuring that healthcare providers meet established quality standards, thereby supporting accountability and transparency within the healthcare industry. By utilizing HEDIS, NCQA can assess various aspects of care, such as preventive services and treatment outcomes, contributing to better healthcare delivery. While the other organizations listed have important roles in healthcare—such as the FDA, which regulates drugs and medical devices; the AMA, which represents physicians and sets ethical standards in medicine; and CMS, which administers Medicare and Medicaid programs—they do not specifically focus on the accreditation of health insurance plans through the HEDIS evaluation system like the NCQA does.