Public Policy

Working with federal and state lawmakers and executive agency personnel

To fulfill its mission to improve the quality of health care, NCQA works with federal and state lawmakers and executive agency personnel. NCQA Public Policy team provides information and comment letters for its government partners. Federal work includes on Medicare Advantage plans, health information technology, and on delivery system reforms such as Patient Centered Medical Home. The Public Policy Department helps state and federal policymakers understand and use NCQA programs to improve the quality, experience and cost of care. NCQA also work in coalition with consumer, employers and other stakeholder groups to advance policies that will improve the quality and efficiency of the health care system.

  

Federal Policy

At the federal level, NCQA Accreditation and performance measures are valued components of health care policy. The new health care reform law has many provisions that connect to NCQA’s mission and capabilities. The law builds on many of NCQA’s successful activities over the past 20 years and challenges us to take more steps to work with federal and state policymakers to improve quality and value through measurement, accountability and transparency.

  • Medicare Advantage

    The federal Medicare program recognizes NCQA Accreditation as meeting many of its central quality standards for MCOs and PPOs.

  • Federal Employee Health Benefits Program

    The U.S. Office of Personnel Management requires its HMOs and fee-for-service plans offering PPOs to collect and report quality performance measures.

  • ACO Crosswalk

    View the crosswalk between NCQA ACO Accreditation and CMS' Shared Savings Program and Pioneer ACO program.

State Policy

Delivery Systems Reform

NCQA has several programs to help health care providers, plans and public payers improve how care is delivery to get better quality, experience of care and costs. These include our:

• Patient-Centered Medical Home program to transform primary care into what patients want it to be.

• Patient-Centered Specialty Practice program to strengthen specialists coordination with primary care provider Patient-Centered Medical Homes. White Paper| Learn More

• Accreditation for Accountable Care Organizations that expand the PCMH model to the entire health care system.

• Program to help health plans and providers communicate effectively and respect the different cultural and linguistic needs of diverse populations.

Exchanges

NCQA is actively engaged with state and federal policy makers and stakeholders to help build Health Insurance Exchanges that help people find affordable care that offers the best value, not just the lowest premium.

Guidance for Policy Makers and Stakeholders

Our Public Policy fact sheets help lawmakers, regulators and other key stakehoders understand key NCQA quality initiatives.

NCQA Public Policy Conference

NCQA Public Policy Conferences focus on hot topics, such as health care exchanges, health IT and the medical home. 

Learn about the 2012 policy conference.

Atul Gawande and NCQA

 

The noted surgeon and author's thoughts on NCQA, quality measurement and public policy.

The State of Health Care Quality Report

NCQA’s main analysis of the quality care of 126 million Americans—about 40% of the U.S. population. Download the report.

  • Resource Library

    NCQA offers a variety of information and resources, including reports, published research, white papers and newsletters.