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, quality measures and patient-centered clinical programs are valued components of health care policy. Both the Affordable Care Act of 2010 and the Medicare Access & CHIP Reauthorization Act of 2015 include many provisions that support and build on NCQA’s mission and capabilities. This includes provisions promoting Patient-Centered Medical Homes, Patient-Centered Specialty Practices, use of quality measures to pay both health plans and clinicians for value, and NCQA’s performance-based Health Plan Accreditation.

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:

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White Papers

A Future Vision of Medicare Value-Based Payment 

Integrating Care for People with Medicare and Medicaid 

Patient-Centered Specialty Practice

The Future of Patient-Centered Medical Homes

Network Adequacy & Exchanges White Paper

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 MA RFI Comments
NCQA urged CMS to add behavioral measures to the Medicare Advantage Star Ratings and remove the benchmark cap that prevents some high quality plans from getting bonuses they have earned.

Medicare Advantage RFI Behavioral Sign-on Letter
NCQA and 15 consumer and behavioral health advocacy groups urged CMS to add behavioral measures to the Medicare Advantage Star Ratings.

NCQA Comments on RFI for PACE and P3C
NCQA provides feedback on RFI for new and existing models of integrated care.

NCQA and 120+ Groups Support Value-based Reforms
NCQA and more than 120 other leading health care organizations are urging Congress to continue focusing on value-based, patient-centered reforms.

NCQA Comments on Final MACRA Rule
NCQA provides comment on the final rule for implementing the Medicare Access & CHIP Reauthorization Act (MACRA). 

NCQA Comments on State Innovation Model RFI
NCQA provides feedback on questions and concepts related to state-based delivery and payment reform initiatives.

NCQA Comments on Proposed 2016 Physician Fee Schedule
NCQA offers feedback on proposed changes to the PFS, highlighting support for proposals to strengthen primary care and patient-centered care management.

NCQA Comments on Patient Relationship Categories and Codes
NCQA recommends that CMS develop an automated decision tree to attribute patients to clinicians for measurement in the Merit-Based Payment Incentive System (MIPS).

NCQA Endorses Medicare Advantage Value-Based Insurance Design Legislation

NCQA Comments on MACRA Measure Development Pla

NCQA Comments on Proposed Rules for MACRA
NCQA Comments on Proposed Rules for MACRA.

NCQA Comments on Medicare Part B Drug Payment
NCQA supports CMS plan to test better drug payment policies.

NCQA Comments on Hospital Star Ratings
NCQA urges CMS to promptly post the Hospital Star Ratings.

NCQA APCD Comments
NCQA urges the Department of Labor to require ERISA plans to report to state All-Payer Claims Databases.

NCQA Comments on Senate Finance Chronic Care Policy Options Document
NCQA provides feedback on the Senate Finance Committee's Bipartisan Chronic Care Working Group Policy Options Document.

NCQA Comments on eMeasure Certification RFI
NCQA feedback on the Request for Information on Certification Frequency and Requirements for the Reporting of Quality Measures under CMS Programs.

NCQA Endorses Medicaid and CHIP Quality Improvement Act
NCQA supports Senator Brown's proposed legislation to measure and improve quality of care for all Medicaid and CHIP beneficiaries.

NCQA Comments on SAMHSA Privacy Updates
NCQA supports SAMHSA proposal to modernize privacy standards to encourage better care coordination and data sharing.

NCQA Comments on Proposed Star Ratings System for Duals
NCQA provides feedback on CMS' effort to develop a star rating system for Financial Alignment Initiative Medicare-Medicaid Plans.

NCQA Comments on Risk Adjusting Medicare Advantage Payment for Duals
NCQA supports CMS' plan to pay Medicare Advantage plans more for the higher cost of serving enrollees eligible for both Medicare and Medicaid. 

NCQA Comments on CMS' Request for Information on Implementing MACRA
NCQA provides detailed comments to CMS on how to implement Medicare's new clinician payment programs.

A Future Vision of Medicare Value-Based Payment
NCQA is proposing 5 key principles for value-based payment under the new Medicare Access & CHP Reauthorization Act (MACRA).

NCQA Comments on Discharge Planning Requirements
NCQA provides comments on the revised requirements for discharge planning for hospitals and home health agencies. 

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 Endorses Medicare Advantage Value-Based Insurance Design Legislation:  Senate VersionHouse 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. 

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.