The NCQA announced updated credentialing standards for 2025, pushing healthcare organizations to meet stricter requirements. The changes reflect a focus on innovation and patient safety, with adjustments to verification turnaround times to align with current industry standards. New guidelines include license monitoring for health plans and capture of social demographic data for providers, aiming to improve equity in healthcare. Healthcare organizations need to adapt to these changes now to avoid playing catch up later. Implementing AI and automation can improve efficiency, reduce costs, and enhance patient care. Healthcare organizations must innovate to meet evolving standards and improve patient outcomes.
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NCQA’s Updated 2025 Standards Have Published: What it Means for Quality and Compliance in Healthcare
