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Quality & Compliance Oversight

Ensuring the absolute best value in healthcare.

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External Quality
Review
Appeals &
Grievances
CMS Waiver
Oversight
CMS Waiver
Oversight
Standard of Care
Review
Standard of Care
Review

An objective, experienced partner
for all of your quality management
and oversight efforts

Acentra Health has decades of experience acting as an independent, impartial third party responsible for quality management and monitoring. In fact, Acentra Health is one of the largest quality improvement organizations (QIO) in the industry, serving government-sponsored healthcare programs.

We can help your program achieve its unique quality goals while keeping your members’ best interests at heart. While our clinical expertise is foundational to all of these offerings, the compassion of our staff is also key to the success of our Quality Oversight solutions.

We have a proven track record of driving change and we are uniquely focused on increasing quality outcomes at all levels of the healthcare system.

Acentra Health has more than 20 years of experience serving as a QIO entity.

Improve healthcare quality oversight with our
cross-functional solutions

External Quality Review

Meet EQR requirements and improve patient care with sophisticated data analysis.

Acentra Health works with states nationwide as an External Quality Review Organization (EQRO). We monitor the quality of programs and services provided by each agency’s managed care partners, validating quality measures, assessing performance improvement projects (PIPs) and conducting scheduled compliance reviews.

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Appeals & Grievances

Reach successful conclusions with flexible processes
that work for your organization's unique systems and criteria.

Acentra Health manages appeals and grievances on behalf of CMS, state Medicaid agencies and commercial plans. Our seasoned team works collaboratively with members and providers to support a diverse range of issues and reach objective conclusions.

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CMS Waiver Oversight

Achieve high-quality long-term services and supports with comprehensive Medicaid waiver oversight and accountability.

Acentra Health partners with states to ensure quality across all Medicaid authorities involved in long term services and supports, including Medicaid waiver programs. Our oversight solutions help our clients operate cross-cutting improvement initiatives and meet required quality of care assurances.

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Standard of Care Review

Promote continuous quality improvement through objective quality reviews.

We ensure the quality of services to beneficiaries is consistent with
professionally recognized standards of healthcare.

Acentra Health's decades of clinical expertise and focus on quality
outcomes ensure our client's quality management initiatives
are advanced and positive outcomes are achieved.

Learn more

CMS Waiver Oversight

Achieve high-quality long-term services and supports with comprehensive Medicaid waiver oversight and accountability.

Acentra Health partners with states to ensure quality across all Medicaid authorities involved in long term services and supports, including Medicaid waiver programs. Our oversight solutions help our clients operate cross-cutting improvement initiatives and meet required quality of care assurances.

Learn more

Standard of Care Review

Promote continuous quality improvement through objective quality reviews.

We ensure the quality of services to beneficiaries is consistent with professionally recognized standards of healthcare.

Acentra Health's decades of clinical expertise and focus on quality outcomes ensure our client's quality management initiatives are advanced and positive outcomes are achieved.

Learn more

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1600 Tysons Blvd,
Suite 1000
McLean, VA 22102

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