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NCQA Prevalidation Program

As the health care system expects health care providers to provide more value by achieving the “Triple Aim”— better quality, lower costs and improved patient experience—there is also a need for technology that helps practices provide better, more patient-centered care. 

This is where NCQA’s prevalidation program can help. NCQA created the prevalidation program to identify electronic health record (EHR) systems, advanced registries, population health management tools and other related technology solutions that have functionality that helps practices meet NCQA PCMH or PCSP Recognition requirements.

How do HIT vendors earn prevalidation?

Organizations with a technology solution that fully meets one or more NCQA PCMH or PCSP factor level requirements submit documentation to NCQA about the program’s functionality. After reviewing that documentation, NCQA determines if a solution earns prevalidation status and whether/how many autocredit points can be awarded. 

Autocredit points are related to factor level requirements in NCQA PCMH and PCSP Recognition standards. If a practice uses a prevalidated HIT solution that is awarded autocredit points, the practice using that solution can earn automatic credit for the factor requirements for which their HIT solution earned points without having to submit documentation to NCQA for those factors. 

HIT solutions that earn prevalidation status but do not achieve autocredit points still contain reporting functions and capabilities that support practices in meeting factor level requirements, even though practices may not automatically earn a score.

What are the benefits of prevalidation to HIT vendors?

  • Provide value-added client benefit. Practices using HIT solutions that meet NCQA Recognition program factors level requirements can earn automatic credit. This credit means practices using your solution have a lower administrative burden of providing supporting documentation, thus saving time.
  • Gain a competitive edge. Vendors can advertise direct alignment of HIT functionality with factor level requirements. The Approval Table provided by NCQA to vendors whose solution has earned prevalidation makes it easy to identify which factors the solution helps the practice meet.
  • Access industry resources. Enjoy an ongoing, collaborative relationship with NCQA and gain frontline details about planned policy changes and enhancements to NCQA PCMH and PCSP Recognition Program requirements.

I have a HIT product and I’d like to learn more about becoming PCMH or PCSP Prevalidated vendor. How do I learn more? 

The first steps is submitting an inquiry to NCQA through My NCQA . You can learn more about the full process here.

I’m a practice considering PCMH or PCSP Recognition. How does working with a prevalidated vendor help me? 

An NCQA prevalidated HIT solution can expedite the PCMH or PCSP Recognition survey process:

  • Support practice goals with your HIT solution. Prevalidation solutions align with NCQA PCMH or PCSP standards, supporting your practice’s transformation into an effective medical home.
  • Save documentation time. If your HIT solution meets certain requirements, you can earn automatic credit for some NCQA PCMH or PCSP factors, eliminating the need to provide documentation, which saves time. The Approval Table provided by NCQA to vendors whose solution has earned prevalidation makes it easy to identify which factors the solution helps the practice meet
  • Maintain recognition. A prevalidated product may help you better document factor level requirements over time, easing the renewal process.

How do I know what solutions have earned PCMH or PCSP Prevalidation? 

NCQA keeps a directory of all HIT vendors with NCQA prevalidated solutions that have been prevalidated by NCQA. You can find the directory of prevalidated systems here.  

How do I find out what factors a HIT solution supports?

In the vendor directory there is a direct link for practices inquiring about prevalidation that leads to a HIT vendor’s company web site. When you contact the vendor, they will be able to discuss and share in an NCQA issued Approval Table which Factors the solution supports based on its earned prevalidation status.

I’m a practice that is using a HIT solution that is prevalidated. What next? 

You can learn more about practice eligibility and steps for using a prevalidated solution during the survey process here