FAQ Directory

Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can  ask a question through My NCQA.

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11.17.2008 PHQ and Physician Practice Connection Recognition Do you have a crosswalk for PHQ as it relates to Physician Practice Connection (PPC) Recognitionstandard 8 in particular?

No. The PHQ standards evaluate organizations that measure physician performance; PPC recognizes physician practices that use systematic processes and information technology to enhance quality of patient care. The two programs serve different purposes. In particular, PPC 8: Performance Reporting and Improvement focuses on the practices internal measurement and quality improvement process. It does not address the methodology required in PHQ, but focuses on the QI process.

11.17.2008 Use of rental networks and hospital quality For PHQ 2, Element E, if we "rent" our national hospital network and do not contract directly, may we share hospital results with the entity we rent from, rather than the individual hospitals?

Each hospital must receive results. Either the organization must provide results to each hospital or it may have a written agreement with the national network stating that it will provide results to hospitals. If the national network provides results to each hospital, it must provide documentation (e.g., reports, materials) to the organization that it has met the requirements.

11.17.2008 Small physician sample size If only a small percentage of available physicians in any specialty within a market have sufficient NQF measures available, may there be an assumption of appropriate quality, thus allowing members access to higher benefits with a larger number of physicians?

Yes. Assumption of appropriate quality in this context is permitted.

11.17.2008 Methodology for evaluation of cost measures What constitutes an acceptable methodological approach to evaluation of cost?

NCQA does not prescribe the cost measures an organization selects, though it requires an organization to specify all aspects of its methodology (Element C). In addition, the organization must risk-adjust its measures (Element C, factor 8) and must meet the minimum statistical requirements for measurement error and measure reliability (Element H, factor 2).

9.15.2008 Applications for PHQ surveys How long after NCQA receives an application for survey does the survey begin?

NCQA suggests that organizations submit an application for survey at least 90 days in advance of the date requested for their Initial Survey, but applications may be submitted further in advance than 90 days. Organizations should indicate their preferred survey date and NCQA will accommodate them if possible.

9.15.2008 Providing Results and Estimates of Statistical Reliability Element F, factor 3 requires organizations to provide results and estimates of statistical reliability for comparative information to each physician. What evidence must organizations provide to meet factor 3?

To meet the intent of factor 3, the organization must provide physicians with the results of each applicable measure and an estimate of statistical reliability. The organization determines how it expresses the estimate of statistical reliability (e.g., range, standard deviation, confidence interval, coefficient of variation). The organization should also provide descriptive information with the numbers; the estimate of reliability is a numeric value.

9.15.2008 Standardized Measure Specifications For Element A, if physicians may eliminate noncompliant patients as part of the corrections process, are standardized measures still considered to be nationally recognized?

If a patient is removed from a measure for not taking prescribed medication or for not following recommended treatment, the measure is not considered standardized. If the patient meets specific exclusion criteria listed in the specifications and is removed from the measure, the measure is considered standardized.