Shearwater Health Earns NCQA Accreditation
Shearwater Health, a provider of clinical outsourcing solutions, has earned a three-year Utilization Management Accreditation from the National Committee for Quality Assurance (NCQA). The company achieved a 100% score, which reflects its adherence to quality and compliance standards.
- The National Committee for Quality Assurance (NCQA) is a private, non-profit organization that develops standards and performance measures for a broad range of healthcare organizations. Its Utilization Management Accreditation specifically evaluates how organizations use objective, evidence-based criteria to make fair and timely decisions about the appropriateness of care. - Shearwater Health specializes in a model it terms Clinical Process Outsourcing (CPO), which uses licensed clinicians to perform administrative and support tasks that benefit from clinical expertise. The company employs over 6,000 clinicians globally, with major operations in HITRUST-certified facilities in the Philippines. - The accreditation process is rigorous, typically taking about 12 months from application to decision, and is designed to validate that an organization's systems and processes meet strict national standards for consumer protection and quality improvement. - Shearwater combines its clinical workforce with technologies like Robotic Process Automation (RPA) and methodologies such as Six Sigma to manage processes like utilization review, medical coding, and revenue cycle management. - The CPO model is intended to help U.S. healthcare organizations address the domestic nursing shortage by
