Program Development and Management

Since its inception, NCQA has been a leader in health care quality assessment. NCQA’s experience with evaluating a wide range of health care organizations and providers equips it to provide clients with an unparalleled depth of expertise. For the Centers of Medicare & Medicaid Services, NCQA managements all aspects of the Medicare Health Outcomes Survey, which assesses a health plans’ s ability to maintain or improve the physical and mental health of its Medicare members over time. For the U.S. Department of Veteran Affairs, NCQA developed the first accreditation program of its kind to assess the protection of human research participants. Additionally, NCQA’s physician recognition programs and expertise are used by leading pay-for-performance initiatives, such as Bridges to Excellence and the California P4P Initiative.

Performance Measurement, Benchmarking and Reporting

NCQA has been a pioneer in basing health care evaluation on meaningful, sound, and feasible performance metrics.  NCQA has responsibility for maintaining and implementing ongoing enhancements to the HEDIS® performance measure data set.  HEDIS is the industry standard for measuring health plan performance and is required by both public and private purchasers as well as state regulators. Working with our clients and stakeholders, NCQA has aggressively pursued and supported activities to extend the performance measurement agenda that it successfully pioneered for health plans to other health care sectors. For example, NCQA teamed with the American Medical Association and Mathematica Policy Research in a contract for the Centers for Medicare & Medicaid Services to develop Medicare physician quality measures.

NCQA also works with states, purchaser coalitions and employers to develop objective health plan report cards that help people make better informed decisions.  We have also developed reports aimed at state legislators and policymakers. NCQA develops each report taking into account the specific needs of the sponsors. We are experienced in testing report card prototypes to ensure the information is comprehensible and meaningful to the target audience. NCQA staff members have experience designing reporting formats, producing report content and conducting data analysis.

Data Management and Verification

NCQA has a HEDIS Data Collection Services (HDCS) that offers state agencies an efficient, cost-effective way to collect HEDIS performance measures from health plans.  HDCS is backed by NCQA’s years of nationwide HEDIS data collection experience. The benefits of HDCS to participating States are:

• Collection of data in an efficient and uniform manner
• Delivery of HEDIS data in analysis-ready Microsoft Excel® or SAS file
• Use of the same data submission process and tools health plans are already using for NCQA in order to reduce compliance burden

In addition to many state agencies, the U.S. Office of Personnel Management utilizes NCQA data collection services for the Federal Employees Health Benefits Program.

NCQA worked with Mathematica Policy Research on a Medicare contract to develop a validation strategy that the Centers for Medicare & Medicaid Services can apply to physician-level performance reporting. Using our experience with auditing HEDIS data, NCQA developed a data verification strategy that will support pay-for-performance while also not placing an unreasonable burden on physicians and Medicare.

Training and Technical Support

Since 1994, NCQ has designed and delivered seminars and conferences. NCQA’s professional staff can manage all aspects of program development and presentation, including logistics management. NCQA can offer on-site seminars or conferences, usually held in a conference center or hotel conference facilities; corporate trainings held at the location chosen by the customer organization; and Web-based distance learning presenting the material to attendees via Web and phone access.

In order to increase provider attendance for workshops and seminars, NCQA can provide continuing education credits. For physicians, NCQA is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide AMA PRA Category I credit.  For nurses, NCQA is accredited as a provider of continuing education by the American Nurses Credentialing Center's Commission on Accreditation.

Custom Analysis

The National Committee for Quality Assurance (NCQA) maintains several data sources on the quality of health care.  Detailed data of health plans and national and regional benchmarks are available for purchase through Quality Compass.  NCQA also provides analytical support for creation of customized reports to meet unique needs or to answer specific questions. The Analysis team has generated many ad hoc reports using data sources from NCQA that are not already available in Quality Compass.

Several past examples include:

• Combined Breast Cancer Screening Rates from the states of Vermont, New Hampshire, and Maine
• Comparison of HEDIS rates for publicly and non-publicly reporting health plans by national and state averages
• Comparison of HEDIS rates by data source (administrative or hybrid sources)

Custom analytical requests are reviewed on a case by case basis and a fee may apply to compensate for the use of staff time. If you are interested in using NCQA’s analytical services, please contact Customer Support.