Important Note about PHQ 2006

On March 2, 2008, NCQA announced proposed standards for Physician and Hospital Quality (PHQ) 2008. Effective that date, NCQA stopped accepting applications for survey on the PHQ 2006 standards referred to on this page. Information on PHQ 2006 remains applicable to those organizations already scheduled for PHQ 2006 survey and those organizations that have already received PHQ 2006 distinction. Information on the Member Connections (MEM) and Care Management and Health Improvement (CHI) programs is still valid. For more information on the PHQ 2008 program, click here.

The Physician and Hospital Quality (PHQ) standards evaluate how health plans measure the quality and cost of care provided by network physicians and hospitals. Purchasers have expressed a strong desire for such information. The standards ask:

• Which quality and cost (or resource use) measures a plan uses to measure physicians
• Whether the plan addresses key methodological issues for physician measurement
• What action the plan takes based on results of physician measurement
• Whether the plan engages in collaborative activities to measure physician performance—either with other plans or by supporting physician-initiated measurement activities.
• What all-payer data sources the plan uses to report hospital performance and whether the information is presented in a format that supports member decision-making
• How the plan works with physicians and hospitals to share and seek information
• What the plan shares with customers—including results, methodology and information about the scope of its measurement activities

Four key principles served as the foundation for development of the Physician and Hospital Quality standards:

• Standardization: NCQA supports standardized measures; where it is not possible, it encourages the drive towards standardization. Quality and resource use measures must be evidence-based, reliable and valid.
• Transparency: These standards require that measurement specifications be available to the organizations being measured and the public.
• Collaboration: These standards encourage collaboration between plans by streamlining the review process for organizations participating in collaborative initiatives. The standards also support collaboration between plans and providers—a key to successful measurement activities.
• Action: The objective of measurement is quality improvement and affordability. Plans should take specific actions to improve performance; such as reporting and engaging in quality improvement activities or using payment and product design strategies.