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Physician and Hospital Quality Certification

NCQA’s Physician and Hospital Quality (PHQ) certification program evaluates how well organizations measure and report the quality and cost of physicians and hospitals. The PHQ seal represents an impartial third-party certification of provider measurement programs, and provides assurance that such efforts use valid, transparent methodologies, and measure on quality—not cost alone.

More than 60 health plans have achieved Distinction in Physician and Hospital Quality through the 2006 version of the program. In 2008, NCQA released a PHQ Certification program reflecting changes in the provider measurement field and demand from purchasers and regulators.

This program is open to any organization conducting functions evaluated by the standards, whether a health plan, a measurement collaborative, a provider network or an information provider such as a Web site.

Four key principles serve as the foundation of PHQ Certification:

  • Standardization and sound methodology. This allows results to be compared across organizations.
  • Transparency. Organizations should offer physicians the opportunity to provide input on measurement programs. Organizations should also provide clear, understandable information about how the results will be used.
  • Collaboration. Where possible, organizations should pool their data on standardized
    measures to produce results with greater statistical reliability.
  • Action on quality and cost. Organizations should not sacrifice quality for cost reduction. Organizations must not use results of cost measurement alone.

New Online Application Process

A new application and scheduling process begins May 15 for Certification programs. Learn more.

NCQA Policy Support

Policy Updates

Corrections, clarifications and policy changes to our stated Standards and Guidelines 

New FAQs are posted on the 15th of every month and provide answers to our most commonly asked questions. 

Policy Clarification Support (PCS)
If you cannot find an answer to your question in our FAQs or Policy Updates, submit your inquiry here

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HEDIS Users Group (HUG)
HUG membership packages offer you access to the most up-to-date information on HEDIS specifications so you can begin planning for the future.

HEDIS and ICD-10
To accommodate the switch from ICD-9-CM to ICD-10, NCQA created a plan to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure.