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.

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 Homes Evidence - Patient-Centered Medical Homes are driving some of the most important reforms in health care delivery today. A growing body of scientific evidence shows that PCMHs are saving money by reducing hospital and emergency department visits, reducing health disparities, and improving patient outcomes. The evidence we present here outlines how the medical home inspires quality in care, cultivates more engaging patient relationships, and captures savings through expanded access and delivery options that align patient preferences with payer and provider capabilities. 
  • 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.
  • Integrating Care for People with Medicare and Medicaid White Paper
  • Program to help health plans and providers communicate effectively and respect the different cultural and linguistic needs of diverse populations.

Learn More

Fact Sheets

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

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Comment Letters

NCQA Comments on Proposed Medicare Physician Fee Schedule
NCQA discusses principles for MACRA implementation and moving Medicare to paying for value.

NCQA Comments on Medicaid Managed Care Proposed Rule
NCQA supports harmonizing Medicaid rules with those for Medicare and Marketplace plans, but does not believe states should apply private accreditor standards. 

NCQA Comments to the Senate Finance Committee on Improving Chronic Care
Improving chronic care for Medicare enrollees is a priority to NCQA.

NCQA Comments on Stage 3 of Meaningful Use
NCQA supports advancing use of health IT to improve health care quality. 

NCQA Endorses Medicare Advantage Value-Based Insurance Design Legislation:  Senate Version, House Version
This important legislation authorizes a demonstration allowing Medicare Advantage plans to use value-based insurance designs to lower or eliminate cost sharing to promote evidence-based, high-value drugs, clinical services and providers. 

Rewarding Physicians Who Deliver High Quality Care
NCQA supports legislation to pay physicians for value instead of volume of care.

NCQA Comments on Medicare Advantage
NCQA cautions CMS that socioeconomic risk adjustment may have unintended consequences. 

NCQA Comments on 21st Century Cures
NCQA supports initiative to advance medical research.

NCQA Comments on Graduate Medical Education
NCQA urges Congress to focus graduate medical education on patient-centered deliver system reforms.

NCQA Comments to Senate Finance on Data 

NCQA Comments to NQF on SES Risk Adjustment
NCQA supports alternatives to socioeconomic risk adjustment to address disparities that do not lock in lower expectations.

Medicaid and CHIP Continuous Quality Act Endorsement
NCQA endorses legislation providing 12-month continuous coverage and standardized quality measurement for all Medicaid and CHIP enrollees, including those in fee-for-service. 

Accrediting Highly-Qualified Accountable Care Organizations

Atul Gawande and NCQA


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


NCQA Health Quality Awards - April 2, 2014

The NCQA Health Quality Awards recognizes individuals who have demonstrated an ongoing commitment to improving the quality of health care.View this year's past honorees.

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.