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 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 ONC's 2016 Interoperability Standards Advisory
NCQA provides feedback to ONC on the best available standards and implementation specifications to achieve HIT interoperability

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 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.


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.