About NCQA

WHY WE’RE HERE

Our Mission: Improve the quality of health care.

Our Vision: Better health care. Better choices. Better health.

NCQA:

  • Points the way to health care that science says works.
  • Studies how well health plans and doctors provide scientifically recommended care.
  • Identifies organizations that are run in ways that make care better.

Our Work:

  • Saves thousands of lives.
  • Helps millions of people stay healthy.
  • Saves the country billions of dollars.

Before NCQA, health care was operating data-free and “in the dark.

We were founded as an independent nonprofit in 1990 to “turn on the lights.

Signs beside the elevators in our Washington, DC offices tell visitors who we are and what we’re about.

WHAT WE DO

We use measurement, transparency and accountability to highlight top performers and drive improvement.

We began in the early 1990’s by measuring and then accrediting health plans.

Since 2008, our mission has brought us closer to where care is delivered: We’ve grown to measure the quality of medical providers and practices.

Most of our employees work on HEDIS and our Accreditation, Certification and Recognition programs.

Government and private sector clients hire us through contracts and grants to help them measure and improve quality.

Accomplishments

Our annual report highlights stories and milestones of the previous year. What we are most proud of:

HEDIS

More than 184 million peopleover half our country’s population—are enrolled in health plans that report quality results using our Healthcare Effectiveness Data and Information Set. Americans receive better care and can lead healthier lives thanks to the accountability and benchmarking that HEDIS makes possible.

Health Plan Accreditation

Our industry-leading accreditation is a rigorous assessment of health plans’ structure and processAccreditation standards: Assess whether health plan is organized in ways that protect and improve quality., clinical qualityHEDIS measures: Calculate the “rate” or proportion of people who receive recommended tests, screenings or treatments. and patient satisfactionCAHPS® survey: Consumer Assessment of Healthcare Providers and Systems.. More than 173 million people are enrolled in NCQA-Accredited health plans.

Patient-Centered Medical Home (PCMH) Recognition

A medical home is not a place, but a way to organize primary care so it’s “the way patients want it to be.” Since 2008 we have built the most widely used medical home model. More than 13,000 practice sites and 67,000 clinicians have earned the NCQA PCMH Recognition seal.

High Country Community Health Center CEO Alice Salthouse shares her thoughts about PCMH in the video below.

Quality Solutions Group

Our consulting team works with hundreds of organizations to help them measure and improve quality. Different departments at NCQA work on about 50 consulting contracts at a time.

HOW WE WORK

Teams

We can’t measure and improve quality by ourselves.

People who use, provide or pay for health care help define what we do. A public comment period is a vital step in creating or changing NCQA products.

More than a dozen external committees and advisory groups help us plan and achieve our mission, including:

Leaders

Our 12-person Leadership Team includes our founder, Margaret E. O’Kane. She started NCQA almost 30 years ago, working by herself in a borrowed office.

An energetic and engaged Board of Directors directs strategy and governance. Leaders from health plans, provider organizations, employers and universities make up our board.

Systems

We believe better health care depends on how care is organized.

We create standards and guidelines to measure performance, so it makes sense that we believe in standardization: Trying to improve by doing certain things the right way, at the right time, every time.

  • Measure. Analyze. Improve. Repeat: This is the heart of our work. We make measuresHEDIS measures: Calculate the “rate” or proportion of people who receive recommended tests, screenings or treatments. and standardsAccreditation standards: Assess whether an organization is organized in ways that protect and improve quality. that health care professionals use to identify areas they can improve. Public reporting of performance against our measures and standards becomes the focus for groups we evaluate and for their customers. Releasing results to the public helps everyone set higher goals and continue improving.
  • The Triple Aim: In some fields, getting more means paying more. But health care is different. The “triple aim” of lower costs, better health and better patient experience is an achievable ideal. Evidence shows that delivering coordinated care at the right time can cost less and lead to healthier and more satisfied patients.
  • Effortless Experience: We try to be a great place to work with. Improving health care is hard; working with NCQA should be easy. We define good health care as the “right care, at the right time, every time,” and we want to give “the right answer, the first time, every time” to colleagues and customers.

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

CAHPS® is a registered trademark of the Agency for Healthcare Quality and Research (AHRQ).

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