NCQA Releases HEDIS® Specifications for Measurement of Physician Clinical Quality

Building upon established measures of care, new physician guidelines support electronic data collection

WASHINGTON—The National Committee for Quality Assurance (NCQA) today published an expanded set of measures, guidelines and technical specifications to allow for standardized, equitable assessment of physician practice quality. The new specifications are based on HEDIS®, the most widely used performance measurement tool in health care.

The new publication, HEDIS Technical Specifications for Physician Measurement, introduces more than 40 measures of clinical quality, sets standards for the measurement of the cost of care and provides standardized methods of data collection at the physician office level. The specifications account for collection of data from electronic data systems such as electronic medical records in addition to administrative claims data and paper medical records. 

“Today, making objective, reliable comparisons on physician quality is quite challenging,” said NCQA Vice President for Performance Measurement Joachim Roski, PhD, MPH. “Our approach builds on our proven track record in health plan assessment as well as the experience of physician practices, health plans and community collaboratives to create a fair, equitable set of measures and guidelines supporting performance measurement at the physician practice level.”

NCQA has been involved in physician quality measurement for over a decade; its popular Physician Recognition programs currently recognize more than 5,000 doctors nationwide for excellence in diabetes and heart/stroke care, as well as clinical information management. NCQA physician quality measures have been endorsed by the National Quality Forum and adopted by such leading quality organizations as the National Voluntary Consensus Standards for Physician-Focused Ambulatory Care. Many NCQA physician measures have also been approved as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care by the Ambulatory Quality Alliance, a coalition of medical groups, employers, consumers, public sector purchasers and health plans.

HEDIS — Physician Measurement also spells out guidelines for the use of commonly used software tools in the service of measuring cost of care, such as episode-grouping tools or person-risk adjustment tools. Many health plans and employers use such programs to measure the cost and appropriateness of care delivered by physicians after adjusting for risk, disease severity or both.

To order a copy of the volume in either electronic or hard copy form, contact NCQA Customer Support at (888) 275-7585 between 8:30 and 5:30 Eastern time, or log on to NCQA’s Web site at www.ncqa.org.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes physicians in key clinical areas. NCQA’s Health Plan Employer Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care.  NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices.

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